Organization
OPDYKE MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE THERESE CRUM (ADMINISTRATOR)
(248) 240-5699
Entity
Organization
Contact information
Practice address
3959 CENTERPOINT PKWY STE 100, PONTIAC, MI 48341-3121
(248) 333-2600
(248) 333-3250
Mailing address
3959 CENTERPOINT PKWY STE 100, PONTIAC, MI 48341-3121
(248) 333-2600
(248) 333-3250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2805350
—
MI
Enumeration date
04/03/2013
Last updated
04/13/2023
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