Search › Michigan › 363AS0400X
Justin Severance
NPI 1518413244 · on the registry since 2016
Practice
- Address
- 2799 W Grand Blvrd
Detroit, MI 48202 - Phone
- (313) 916-2695
Registry record
- Primary taxonomy
- 363AS0400X
363AS0400X
- Also registered as
- 363A00000X
- Licence states on file
- MT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-12-14
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan