Organization
MICHIGAN INSTITUTE OF MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH JEFFREY PIERCE MD (PRESIDENT)
(313) 563-3332
Entity
Organization
Contact information
Practice address
38525 8 MILE RD, LIVONIA, MI 48152-1012
(734) 542-5512
(734) 542-3115
Mailing address
38525 8 MILE RD, LIVONIA, MI 48152-1012
(734) 542-5512
(734) 542-3115
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108225041
BLUE SHIELD
MI
01
—
110H225041
BCBS
MI
05
—
4905908 -10
—
MD
Enumeration date
01/25/2007
Last updated
03/07/2012
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