Organization
G&M MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA FOSNAUGH AVIS RN (CLINIC DIRECTOR)
(248) 353-6880
Entity
Organization
Contact information
Practice address
20240 W 12 MILE RD, SOUTHFIELD, MI 48076-2426
(248) 353-6880
(248) 353-6887
Mailing address
20240 W 12 MILE RD, SOUTHFIELD, MI 48076-2426
(248) 353-6880
(248) 353-6887
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
MI
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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