Organization
UNIVERSAL CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA ILYAYEV (MANAGER)
(248) 569-5100
Entity
Organization
Contact information
Practice address
18597 W 10 MILE RD, STE #1, SOUTHFIELD, MI 48075-2663
(248) 569-5100
(248) 569-4774
Mailing address
PO BOX 198, SOUTHFIELD, MI 48037
(248) 569-5100
(248) 569-4774
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
—
Other
Enumeration date
06/16/2006
Last updated
08/22/2020
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