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Organization

RENAL CENTER PHYSICIANS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUBBANA GOUNDER MUTHUSWAMI MD (PRESIDENT)
(810) 987-5252
Entity
Organization

Contact information

Practice address
2607 ELECTRIC AVE STE E, PORT HURON, MI 48060-6587
(810) 987-5252
(810) 987-2120
Mailing address
22201 MOROSS RD STE 150, DETROIT, MI 48236-2152
(586) 247-4300
(586) 532-6496

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102570422
MI
Enumeration date
07/04/2006
Last updated
06/17/2008
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