Organization
SOUTH MACOMB INTERNISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY BARON MD (OFFICER)
(586) 751-2072
Entity
Organization
Contact information
Practice address
11900 E 12 MILE RD, SUITE 300, WARREN, MI 48093-3400
(586) 761-2072
(586) 751-1302
Mailing address
11900 E 12 MILE RD, SUITE 300, WARREN, MI 48093-3400
(586) 761-2072
(586) 751-1302
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700E06357
BCBSM
MI
Enumeration date
09/02/2005
Last updated
07/14/2007
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