Individual
DR. ANNE MARE ICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23077 GREENFIELD RD STE 200, SOUTHFIELD, MI 48075-3750
(313) 824-1000
Mailing address
22341 W 8 MILE RD, DETROIT, MI 48219-1217
(313) 255-2209
(313) 255-0773
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301031683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1066910
—
MI
Enumeration date
07/07/2006
Last updated
05/09/2024
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