Medistat

NPI #1851688428 in Belleville, Michigan

Provider Information

NPI Number: 1851688428
Entity Type: Organization
Organization Name: Medistat
Primary Specialty: Specialist
Enumeration Date: Jul 5, 2011
Last Updated: Jul 5, 2011

Practice Location

Address: 8511 OAKVILLE WALTZ RD
City: Belleville
State: Michigan
ZIP Code: 48111-9504
Phone: (248) 914-6015

Authorized Official

Name: MRS. DORTHIA CAROLYN GLOVER, CCEMT-P
Title: PARAMEDIC/MEDICAL ASSISTANT
Phone: (734) 587-2217

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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