Organization
GENERAL MEDICINE OF ILLINOIS PHYSICIANS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS PROSE M.D. (PRESIDENT)
(248) 662-0250
Entity
Organization
Contact information
Practice address
21333 HAGGERTY RD, SUITE 150, NOVI, MI 48375-5510
(248) 662-0250
(248) 662-9844
Mailing address
21333 HAGGERTY RD, SUITE 150, NOVI, MI 48375-5510
(248) 662-0250
(248) 662-9844
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/28/2008
Last updated
11/25/2015
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