Organization
BI COUNTY MEDICAL PRACTICES
Active
Other names
Henry Ford Macomb Hospital Warren
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY GOODBALIAN (CFO)
(586) 263-2705
Entity
Organization
Contact information
Practice address
13355 E 10 MILE RD, SUITE 229, WARREN, MI 48089-2048
(586) 755-6263
(576) 758-7725
Mailing address
PO BOX 673195, DETROIT, MI 48267-3195
(810) 720-5715
(810) 732-0891
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700E000820
BCBSM/BCN
MI
Enumeration date
03/24/2010
Last updated
06/17/2010
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