Organization
IPC HOSPITALIST COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELODY SHAW PA-C (PHYSICIAN ASSISTANT)
(313) 530-9188
Entity
Organization
Contact information
Practice address
1628 HUNTWOOD PARK CT, WEST BLOOMFIELD, MI 48324-3998
(313) 530-9188
Mailing address
1628 HUNTWOOD PARK CT, WEST BLOOMFIELD, MI 48324-3998
(313) 530-9188
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
5601004921
MI
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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