Provider Demographics
NPI:1003319625
Name:PSI MEDICAL
Entity Type:Organization
Organization Name:PSI MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MD
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAFTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-299-6228
Mailing Address - Street 1:555 BARCLAY CIR STE 170
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4574
Mailing Address - Country:US
Mailing Address - Phone:248-299-6228
Mailing Address - Fax:
Practice Address - Street 1:555 BARCLAY CIR STE 170
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4574
Practice Address - Country:US
Practice Address - Phone:248-299-6228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty