Organization
CORONDAN MEDICAL PC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR I CORONDAN M.D. (OWNER)
(248) 837-9419
Entity
Organization
Contact information
Practice address
14050 E 14 MILE RD, WARREN, MI 48088-5765
(586) 920-2249
Mailing address
14050 E 14 MILE RD, WARREN, MI 48088-5765
(586) 920-2249
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301059864
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321078
—
MI
Enumeration date
02/18/2014
Last updated
04/24/2014
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