Organization
METRO MEDICAL PRACTICE PC
Active
Other names
Metro Medical Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALIA RUTKOVSKY (OFFICE MENAGER)
(248) 524-9085
Entity
Organization
Contact information
Practice address
2891 E MAPLE RD, SUITE 102, TROY, MI 48083-6106
(248) 524-9085
(248) 524-9086
Mailing address
2891 E MAPLE RD, SUITE 102, TROY, MI 48083-6106
(248) 524-9085
(248) 524-9086
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
SJ033023
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101958265
—
MI
01
—
132060
CARE CHOICES
MI
01
—
700F325720
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/13/2006
Last updated
02/29/2024
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