Individual
IAN MOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R. N.
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3456
Mailing address
9440 NEWTON CT, COMMERCE TOWNSHIP, MI 48390-1333
(248) 767-2616
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
4704263900
MI
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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