Individual
MR. MILTON JAMES DESGRANDCHAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
255 LEWISTON RD, GROSSE POINTE FARMS, MI 48236-3450
(313) 530-6603
Mailing address
PO BOX 36775, GROSSE POINTE, MI 48236-0775
(313) 530-6603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704158813
MI
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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