STOUT FAMILY MEDICINE PC
Ambulatory Health at Warren Ave, Detroit, MI

License number
Michigan IL005442
Category
Ambulatory Health
Type
Primary Care
Owner
Name: PERRY J OLSON P.A.-C.
Title: OWNER
Phone: (313) 271-0500
Address
Address
20400 W Warren Ave, Detroit, MI 48228
National Provider ID: 1366659807
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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STOUT FAMILY MEDICINE, PC

Detroit, MI

Status:
Inactive
Industry:
Medical Doctor's Office, Family Doctor
Doing business as:
Stout Family Me<br>Stout Family Medicine
Registration:
Oct 31, 2003
Phone:
(313) 271-0500 (Phone), (313) 271-9313 (Fax)
Addresses:
20400 W Warren Ave, Detroit, MI 48228 (Physical)
Michigan (Mailing)
State ID:
08363D
Business type:
Domestic Professional Service Corporation
Medical Assistants:
Amy G. Connelly (Cardiology, Physician Assistant),Perry Olson (Cardiology, Manager, Owner, Physician Assistant),Amy G. Connolly Cardiology, Physician Assistant, inactive,...
Categories:
Physicians' Assistants

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