Organization
DETROIT MEDICAL CENTER COOPERATIVE
Active
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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