Basic Information
| Provider Information | |||||||||
| NPI: | 1669450599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCGOEY | ||||||||
| FirstName: | CLAUDETTE | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1239 LOCHMOOR BLVD | ||||||||
| Address2: | |||||||||
| City: | GROSSE POINTE WOODS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482364012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3138867081 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12851 GRAND RIVER RD | ||||||||
| Address2: | |||||||||
| City: | BRIGHTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481168506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102252506 | ||||||||
| FaxNumber: | 8102271869 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 4301043116 | MI | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.