Individual
MR. DOUGLAS KENT MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, MED
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
19515 CHALON ST, SAINT CLAIR SHORES, MI 48080-1635
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
04/09/2025
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