Organization
BEAUMONT MEDICAL GROUP- SPECIALTY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW E COX (CFO)
(616) 295-4264
Entity
Organization
Contact information
Practice address
4700 SHAEFER RD, DEARBORN, MI 48126
(616) 486-6790
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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