Organization
GREAT LAKES FAMILY MEDICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARUNIMA SHIRVASTAVA M.D. (OWNER)
(734) 266-2780
Entity
Organization
Contact information
Practice address
4420 E DAVISON ST, DETROIT, MI 48212-1744
(313) 369-1500
(313) 369-1205
Mailing address
28801 PLYMOUTH RD, LIVONIA, MI 48150-2385
(734) 266-2780
(734) 466-9615
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/02/2006
Last updated
08/22/2020
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