Organization
GLADWIN FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HICHAM CHURBAJI MD (OWNER)
(989) 426-9399
Entity
Organization
Contact information
Practice address
2137 W M 61, GLADWIN, MI 48624-8463
(989) 426-9399
Mailing address
3061 CHRISTY WAY, SAGINAW, MI 48603-2267
(989) 426-9399
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
SW130169
MI
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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