Individual
SAMUEL MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPRM
Contact information
Practice address
2011 CLEMENTS ST, DETROIT, MI 48238-3484
(313) 962-9446
(313) 502-5147
Mailing address
2011 CLEMENTS ST, DETROIT, MI 48238-3484
(313) 962-9446
(313) 502-5147
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
M200758379939
MI
Other
Enumeration date
06/24/2026
Last updated
06/24/2026
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