Organization
THORREZ MEDICAL PRACTICE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M MCCARREN (OFFICE MANAGER)
(734) 572-8686
Entity
Organization
Contact information
Practice address
2900 PACKARD RD, SUITE 1, YPSILANTI, MI 48197-2060
(734) 572-8686
(734) 572-8866
Mailing address
2900 PACKARD RD STE 1, YPSILANTI, MI 48197-2061
(734) 572-8686
(734) 572-8866
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301035414
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H11972
BCBSM
MI
01
—
350H115430
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/26/2007
Last updated
03/14/2018
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