Organization
MACOMB PRIMARY CARE, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHADI H MANSOUR M.D. (OWNER/PRESIDENT)
(586) 323-0301
Entity
Organization
Contact information
Practice address
851 SOUTH MAIN STREET, SUITE #3, PLYMOUTH, MI 48170
(734) 354-0020
(586) 323-0341
Mailing address
11051 HALL ROAD, SUTIE 120, UTICA, MI 48317
(586) 323-0301
(286) 323-0341
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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