MEDICARE: MICHIGAN HEALTHCARE PROFESSIONALS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician
2	207P00000X	Emergency Medicine Physician
3	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1568285872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN HEALTHCARE PROFESSIONALS, P.C.

Provider Business Mailing Address
First Line	:	29992 NORTHWESTERN HWY STE C
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3292
Country	:	US
Telephone Number	:	248-851-1430
Fax Number	:

Provider Business Practice Location Address
First Line	:	27650 DEQUINDRE RD STE 1200
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48092-2818
Country	:	US
Telephone Number	:	248-544-9050
Fax Number	:	248-544-2331

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	KRISTIE GRIMMETT
Credential	:
Telephone Number	:	248-780-6615

Provider Enumeration Date	:	11/05/2024
Last Update Date	:	03/04/2026

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