Organization
SUBURBAN HEALTHCARE ORGANIZATION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRWIN MARCUS LUTWIN D.O. (OWNER)
(734) 752-6281
Entity
Organization
Contact information
Practice address
1600 KINGSWAY CT, LOWER LEVEL, TRENTON, MI 48183-1962
(734) 752-6281
(734) 752-6559
Mailing address
1600 KINGSWAY CT, LOWER LEVEL, TRENTON, MI 48183-1962
(734) 752-6281
(734) 752-6559
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013979244
BCBS
MI
Enumeration date
07/28/2014
Last updated
08/19/2014
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