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Individual

JIRA G COUMARBATCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
23077 GREENFIELD RD STE 489, SOUTHFIELD, MI 48075-3740
(248) 395-6312
(248) 395-6314
Mailing address
PO BOX 47068, OAK PARK, MI 48237-4768
(248) 443-6911
(248) 443-6594

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301077874
MI

Other

Enumeration date
06/01/2006
Last updated
07/21/2022
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