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Individual

CLETUS NOR STANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
1 FORD PL STE 2E, DETROIT, MI 48202-3450
(248) 802-5256

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301504947
MI
2086S0102X
Surgical Critical Care Physician
4301504947
MI

Other

Enumeration date
03/27/2015
Last updated
06/22/2021
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