Organization
GREAT LAKES DIAGNOSTIC FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAQAR MIAN (OWNER)
(989) 780-4415
Entity
Organization
Contact information
Practice address
1525 W CARO RD, CARO, MI 48723-9686
(989) 672-2100
(989) 672-2120
Mailing address
3061 CHRISTY WAY, SAGINAW, MI 48603-2224
(989) 791-2455
(989) 791-1392
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301059644
MI
Other
Enumeration date
01/09/2015
Last updated
09/10/2015
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