Organization
GOLDINNO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INNOCENT E. AGBASSI M.D. (OWNER)
(313) 282-4328
Entity
Organization
Contact information
Practice address
3360 COOLIDGE HWY, ROYAL OAK, MI 48073-6857
(313) 282-4328
Mailing address
3360 COOLIDGE HWY, ROYAL OAK, MI 48073-6857
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301075373
MI
Other
Enumeration date
01/10/2008
Last updated
01/10/2008
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