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Organization

CITY MEDICAL

Active
Parent organization
CITY MEDICAL PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
CITY MEDICAL PC
Authorized official
THOMAS M PINSON DO (LABORATORY DIRECTOR)
(734) 283-2262
Entity
Organization

Contact information

Practice address
13636 DIX TOLEDO RD, SOUTHGATE, MI 48195-2432
(734) 283-2262
(734) 283-8121
Mailing address
13636 DIX TOLEDO RD, SOUTHGATE, MI 48195-2432
(734) 283-2262
(734) 283-8121

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101009701
MI
291U00000X
Clinical Medical Laboratory
Primary
23D0998952
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23D0998952
CLIA CERTIFICATE OF COMPLIANCE
MI
Enumeration date
05/15/2009
Last updated
05/15/2009
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