PEDICENTER ASSOCIATES, P.C.
Medical Practice at Greenfield Rd, Southfield, MI

License number
Michigan 430(NT)1019821
Category
Medical Practice
Type
Specialist
Owner
Name: NATALIA M TANNER M.D
Title: DOCTOR
Phone: (248) 559-8336
Address
Address
20905 Greenfield Rd STE 207, Southfield, MI 48075
National Provider ID: 1336353515
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PEDICENTER ASSOCIATES, PC

Southfield, MI

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Tanner, Natalia M MD
Registration:
Dec 11, 1969
Phone:
(248) 559-8336 (Phone)
Addresses:
20905 Greenfield Rd, Southfield, MI 48075 (Physical)
15801 Providence Dr, Southfield, MI 48075
State ID:
062183
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2014
Office Manager, Managers:
Natalia M. Tanner President, Pediatrician Adolescent Medcine, Medical Doctor, inactive,Janine Lewis Manager, inactive,Daniel J. Fairrow Office Manager, Manager, inactive

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