Organization
GLADWIN FAMILY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAREK MUSTAPHA EZZEDDINE MD (OWNER)
(989) 426-9399
Entity
Organization
Contact information
Practice address
2137 W M 61, GLADWIN, MI 48624-8463
(989) 426-9399
(989) 246-2257
Mailing address
2137 W M 61, GLADWIN, MI 48624-8463
(989) 426-9399
(989) 246-2257
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301080387
MI
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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