Organization
MEDICINA URBANA WEST VERNOR PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RYAN BEARD DO (MEMBER)
(313) 281-1362
Entity
Organization
Contact information
Practice address
5700 W VERNOR HWY, DETROIT, MI 48209
(313) 586-3066
(313) 586-3165
Mailing address
5700 W VERNOR HWY, DETROIT, MI 48209-2158
(313) 586-7481
(313) 899-7392
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101017883
MI
Other
Enumeration date
11/13/2017
Last updated
05/15/2018
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