Organization
MIDWESTHEALTHCENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE ANN ODOM (PRESIDENT SHARED SERVICES)
(947) 522-3326
Entity
Organization
Contact information
Practice address
5050 SCHAEFER RD, DEARBORN, MI 48126-3249
(313) 581-2600
(313) 581-0228
Mailing address
26901 BEAUMONT BLVD, COMPLIANCE, SOUTHFIELD, MI 48033-3849
(947) 522-1964
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H261900
BCBSM
MI
05
—
3098064
—
MI
Enumeration date
01/17/2008
Last updated
10/21/2021
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