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Organization

GREAT LAKES PHYSICIANS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAYSHREE DESAI MD (OWNER)
(734) 591-7666
Entity
Organization

Contact information

Practice address
36180 FIVE MILE ROAD, LIVONIA, MI 48154
(734) 591-7666
(734) 591-2426
Mailing address
36180 FIVE MILE ROAD, LIVONIA, MI 48154
(734) 591-7666
(734) 591-2426

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3323140
MI
Enumeration date
11/07/2006
Last updated
09/28/2012
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