Organization
DOVETAIL FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN JANE HULSEMANN M.D. (PRESIDENT)
(734) 244-5515
Entity
Organization
Contact information
Practice address
636 BORGESS AVE, MONROE, MI 48162-2713
(734) 244-5515
Mailing address
636 BORGESS AVE, MONROE, MI 48162-2713
(734) 244-5515
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301069503
MI
Other
Enumeration date
10/01/2010
Last updated
10/01/2010
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