Organization
CANCER & LEUKEMIA CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN L MOODY (ADMINISTRATOR)
(586) 323-1500
Entity
Organization
Contact information
Practice address
44344 DEQUINDRE RD, SUITE 260, STERLING HEIGHTS, MI 48314-1038
(586) 323-1500
(586) 323-1515
Mailing address
44344 DEQUINDRE RD, SUITE 260, STERLING HEIGHTS, MI 48314-1038
(586) 323-1500
(586) 323-1515
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110F335760
BCBSM
MA
01
—
DE0432
RR MEDICARE
MI
Enumeration date
06/12/2006
Last updated
09/23/2010
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