Organization
PHYSICIANS RESOURCES NETWORK, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALLY SHERMAN MAHAR M.D. (CEO, CFO, CHAIRMAN OF THE BOARD)
(248) 698-3129
Entity
Organization
Contact information
Practice address
7795 ELIZABETH LAKE RD, WATERFORD, MI 48327-3603
(248) 698-3129
(248) 698-3129
Mailing address
7795 ELIZABETH LAKE RD, WATERFORD, MI 48327-3603
(248) 698-3129
(248) 698-3129
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301030215
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00575Y
MICHIGAN CORPORATION ID
MI
Enumeration date
05/13/2007
Last updated
06/21/2018
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