Individual
MRS. BAN MECHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19930 FARMINGTON RD, SUITE A, LIVONIA, MI 48152-1433
(248) 476-6209
(248) 476-6237
Mailing address
19930 FARMINGTON RD, SUITE A, LIVONIA, MI 48152
(248) 476-6209
(248) 476-6237
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
BM073200
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106331411
BCBS
MI
05
—
440931010
—
MI
Enumeration date
03/03/2006
Last updated
07/11/2012
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