Organization
DETROIT MEDICAL CENTER COOPERATIVE
Active
Other names
DMC COOPERATIVE SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL PELC (VP FINANCE)
(313) 578-2820
Entity
Organization
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3607
Mailing address
DEPT 203401, PO BOX 67000, DETROIT, MI 48267-0001
(313) 578-2820
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N24360
MEDICARE
MI
Enumeration date
05/19/2006
Last updated
09/26/2007
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