Organization
CENTRO MEDICAL PARTNERS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS M PROSE MD (PRESIDENT)
(248) 662-0250
Entity
Organization
Contact information
Practice address
21333 HAGGERTY RD, SUITE 150, NOVI, MI 48375-5510
(248) 662-0250
(248) 662-9845
Mailing address
21333 HAGGERTY RD, SUITE 150, NOVI, MI 48375-5510
(248) 662-0250
(248) 662-9845
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
MI
363L00000X
Nurse Practitioner
—
MI
Other
Enumeration date
03/17/2016
Last updated
08/04/2016
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