Organization
CATHERINE MCAULEY HEALTH SERVICES
Active
Other names
St. Joseph Mercy Primary Care Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
GARRY C FAJA (PRESIDENT CEO)
(734) 975-4101
Entity
Organization
Contact information
Practice address
620 BYRON RD, STE 1200A, HOWELL, MI 48843-1002
(517) 545-6600
Mailing address
2691 RELIABLE PARKWAY, CHICAGO, IL 60686-0026
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350D710310
BCBS BCN
MI
Enumeration date
04/04/2007
Last updated
10/20/2009
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