Organization
MICHIGAN MENTAL WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK GRESHAM M.D. (OWNER)
(313) 408-3006
Entity
Organization
Contact information
Practice address
37935 W 12 MILE RD, SUITE A, FARMINGTON HILLS, MI 48331-6101
(313) 408-3006
Mailing address
37935 W 12 MILE RD, SUITE A, FARMINGTON HILLS, MI 48331-6101
(313) 408-3006
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
5315058344
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
5315058344
MI
Other
Enumeration date
05/03/2016
Last updated
05/03/2016
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