Organization
GREAT LAKES CANCER MGMT SPECIALISTS
Active
Other names
JEROME E SEID MD
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNE CLARK (CHIEF FINANCIAL OFFICER)
(313) 884-5524
Entity
Organization
Contact information
Practice address
11051 HALL RD, STE 120, UTICA, MI 48317-5735
(586) 991-0700
(586) 991-0701
Mailing address
11051 HALL RD, STE 120, UTICA, MI 48317-5735
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
4301056352
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2367159
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
4231200
—
MI
Enumeration date
09/20/2006
Last updated
08/22/2020
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