Organization
MERCY MEMORIAL HOSPITAL CORPORATION
Active
Parent organization
INPT PSY
Organization subpart
Yes
Provider details
NPI number
Legal business name
INPT PSY
Authorized official
MUBEEN MEMON MD (GROUP REP)
(734) 240-1440
Entity
Organization
Contact information
Practice address
718 N MACOMB ST, MONROE, MI 48162-7815
(734) 240-1440
(734) 240-1550
Mailing address
718 N MACOMB ST, MONROE, MI 48162-7815
(734) 240-1440
(734) 240-1550
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E86018
BLUE CROSS
MI
Enumeration date
01/31/2008
Last updated
01/31/2008
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