NPI 1215284583

Divine Medical Center P C

Organisation General Practice Physician Detroit, MI

Practice location

Address: 901 W Grand Blvd, Detroit, MI 48208-2353
Phone: (313) 393-3141
Fax: (313) 393-3144
Mailing address: PO Box 806464, Saint Clair Shores, MI 48080-6464

Authorised official

Name: Cermen Cardona
Title: President
Phone: (313) 393-3141

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Michigan →

Registry record

NPI: 1215284583
Entity type: Organization
NPI issued: 6 Aug 2012
Record last updated: 6 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.