Organization
MICHIGAN INTERNAL MEDICINE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M NADAI (BILLING AGENT)
(248) 547-3914
Entity
Organization
Contact information
Practice address
928 BLOOMFIELD KNOLL DR, BLOOMFIELD HILLS, MI 48304-2015
(248) 761-5185
Mailing address
928 BLOOMFIELD KNOLL DR, BLOOMFIELD HILLS, MI 48304-2015
(248) 761-5185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301075318
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104702923
—
MI
01
—
1106304251
BCBSM
MI
Enumeration date
12/28/2007
Last updated
01/24/2018
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