Individual
DR. ANITA MONCREASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1151 TAYLOR ST, DETROIT, MI 48202-1732
(313) 876-4300
Mailing address
1151 TAYLOR ST, DETROIT, MI 48202-1732
(313) 876-4300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301048836
MI
208000000X
Pediatrics Physician
4301048836
MI
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301048836
MI
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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