Organization
MACOMB HEMATOLOGY ONCOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EFSTATHIOS TAPAZOGLOU MD (PROVIDER)
(586) 558-4700
Entity
Organization
Contact information
Practice address
11900 E 12 MILE RD, SUITE 210, WARREN, MI 48093-3400
(586) 558-4700
(586) 558-4706
Mailing address
1122 BALFOUR ST, GROSSE POINTE PARK, MI 48230-1327
(586) 558-4700
(586) 558-4706
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ET040673
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102880283
—
MI
Enumeration date
06/03/2006
Last updated
07/17/2009
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