Organization
CONANT FAMILY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASUDA POLI (OWNER)
(917) 588-1632
Entity
Organization
Contact information
Practice address
3611 CARPENTER ST STE 5, DETROIT, MI 48212-2784
(917) 588-1632
Mailing address
3611 CARPENTER ST STE 5, DETROIT, MI 48212-2784
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301073086
MI
Other
Enumeration date
03/14/2018
Last updated
05/01/2018
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