| Great Lakes Diagnostic Facility Llc | |
|
1525 W Caro Rd Caro MI 48723-9686 | |
| (989) 672-2100 | |
| (989) 672-2120 |
| Full Name | Great Lakes Diagnostic Facility Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1525 W Caro Rd, Caro, Michigan |
| Authorized Official Name and Position | Waqar Mian (OWNER) |
| Authorized Official Contact | 9897804415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Diagnostic Facility Llc 3061 Christy Way Saginaw MI 48603-2224 Ph: (989) 791-2455 | Great Lakes Diagnostic Facility Llc 1525 W Caro Rd Caro MI 48723-9686 Ph: (989) 672-2100 |
| NPI Number | 1609265941 |
|---|---|
| Provider Enumeration Date | 01/09/2015 |
| Last Update Date | 09/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609265941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301059644 (Michigan) | Primary |
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