OrganizationActive
Acadian Supreme Health Services
NPI 1871108217 · Family Medicine Physician · Southgate, MI
Provider details
- NPI number
- 1871108217
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ingrid Lewis, Authorized Official/Fnp(313) 930-0258
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Practice location
12866 Fort St
Southgate, MI 48195-1060
Phone: (313) 930-0258
Approximate (ZIP-level) locationGet directions
Mailing address
20831 Ridgemont Rd
Harper Woods, MI 48225-1137
Registry dates
- Enumerated
- 2020-09-12
- Last updated
- 2020-09-12
- Certified
- 2020-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.