Organization Name: | MICHIGAN MEDICAL PC |
NPI Number: | 1134395239 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT HARRING (CFO) |
Mailing Address: | 17691 174th Ave Spring Lake |
State: | MI US |
Postal Code: | 494569750 |
Phone Number: | 6168421276 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2008 |
NPI Last Update Date: | 05/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |