Individual
INTA J ERTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1051 NORTH CANTON CENTER RD, CANTON, MI 48187-5097
(734) 844-5400
Mailing address
3621 S STATE ST, 700 KMS PLACE ATTN ELLEN KAYFES, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301025548
MI
2080P0207X
Pediatric Hematology & Oncology Physician
4301025548
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4424521
—
MI
Enumeration date
07/27/2006
Last updated
03/05/2012
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