Facts
- Status
- A
- Credential
- CHW
- Type
- Individual
- Enumeration date
- 2025-04-02
- Last updated
- 2025-04-02
Specialties
Licenses
- License MI
- Number not in the file
Location
- Practice location
- 2676 YEMANS ST
- City
- HAMTRAMCK MI
- Postal code
- 482124019
- Phone
- 517-862-0062
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.