NPI 1417001660

Southeast Michigan Medical Associates PC

Organisation Internal Medicine Physician Lathrup Village, MI

Practice location

Address: 18451 W 12 Mile Rd STE 200, Lathrup Village, MI 48076-2644
Phone: (248) 827-7612
Fax: (248) 827-7615

Authorised official

Name: Ashok Kumar Bansal
Title: President
Phone: (248) 827-7612

Registered specialties

Internal Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207R00000X Licence 4301057441 (MI)

Other Internal Medicine providers in Michigan →

Registry record

NPI: 1417001660
Entity type: Organization
NPI issued: 23 Jan 2007
Record last updated: 21 Feb 2017

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.