A.w.c. Fairclough Md Pc

NPI 1104144526 - Internal Medicine - 207RG0100X

NPI Details
NPI 1104144526
Enumeration Date 05/10/2010
Last Updated 07/27/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name ANTHONY ANTHONY
Position PRESIDENT
Phone (248) 334-4773
Fax (248) 334-8230
Practice Location
989 UNIVERSITY DR
SUITE 107
PONTIAC MI, 48342-1885, US
Phone (248) 334-4773
Fax (248) 334-8230
Business Location
989 UNIVERSITY DR
SUITE 107
PONTIAC MI, 48342-1885, US
Phone (248) 334-4773
Fax (248) 334-8230
Toxanomy
Taxonomy Code 207RG0100X
License State Michigan
License Number AF036119
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According to our database, A.w.c. Fairclough Md Pc NPI is 1104144526, taxonomy code is 207RG0100X and license number is AF036119, license state is located at Michigan. A.w.c. Fairclough Md Pc physically located at 989 University Dr, Pontiac MI, 48342-1885. NPI Number 1033115704 has the healthcare provider type.

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1104144526 NPI number is provided on an as is basis without warranty of any kind. 1104144526 is maintained by the National Plan & Provider Enumeration System. The contents of A.w.c. Fairclough Md Pc are for informational purposes only.