Organization
SINAI GRACE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLETA POYDRAS PA-C (PHYSICIAN ASSISTANT)
(313) 515-7828
Entity
Organization
Contact information
Practice address
9358 LOUIS, REDFORD, MI 48239-1746
(313) 515-7828
Mailing address
9358 LOUIS, REDFORD, MI 48239-1746
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
363A50400X
MI
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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