Organization
FAMILY HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE M LEROY (BUSINESS MANAGER)
(734) 362-5132
Entity
Organization
Contact information
Practice address
19020 FORT ST, RIVERVIEW, MI 48193-6701
(734) 362-5100
(734) 362-5147
Mailing address
19020 FORT ST, RIVERVIEW, MI 48193-6701
(734) 362-5100
(734) 362-5147
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700H21076
BCBSM
MI
01
—
CC3713
RR MEDICARE
MI
Enumeration date
05/17/2006
Last updated
08/22/2020
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