Organization
EAST SIDE MEDICAL SERVICES P C
Active
Other names
EDGEWOOD CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHD S JAFRI M.D. (DOCTOR)
(586) 445-3070
Entity
Organization
Contact information
Practice address
22790 HARPER AVE, SUITE A, SAINT CLAIR SHORES, MI 48080-1831
(586) 445-3070
(586) 445-3072
Mailing address
22790 HARPER AVE, SUITE A, SAINT CLAIR SHORES, MI 48080-1831
(586) 445-3070
(586) 445-3072
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301031532
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285498
—
MI
Enumeration date
08/21/2010
Last updated
01/05/2011
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