A.W.C. FAIRCLOUGH MD PC
Osteopathic Medicine at University Dr, Pontiac, MI

License number
Michigan AF036119
Category
Osteopathic Medicine
Type
Internal Medicine
License number
Michigan AF036119
Category
Osteopathic Medicine
Type
Gastroenterology
Owner
Name: DR. ANTHONY FARICLOUGH MD
Title: PRESIDENT
Phone: (248) 334-4773
Address
Address
989 University Dr SUITE 107, Pontiac, MI 48342
National Provider ID: 1104144526
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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A.W.C. FAIRCLOUGH, MD, PC

Pontiac, MI

Status:
Inactive
Registration:
Oct 6, 2006
Addresses:
Ste 10 STE 107, Pontiac, MI 48342 (Physical)
Michigan (Mailing)
State ID:
00122U
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2010
Agent:
Dr. Anthony W.c. Fairclough

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