MEDICARE: PERSONAL HEALTH CARE, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	5101008594	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0Q26421	OTHER	MI	BLUE CROSS BLUE SHIELD OF MICHIGAN

General Provider Information

NPI Number	:	1750454849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL HEALTH CARE, P.C.

Provider Business Mailing Address
First Line	:	22021 ECORSE RD
Second Line	:
City	:	TAYLOR
State	:	MI
Zip	:	48180-1847
Country	:	US
Telephone Number	:	313-291-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	22021 ECORSE RD
Second Line	:
City	:	TAYLOR
State	:	MI
Zip	:	48180-1847
Country	:	US
Telephone Number	:	313-291-4444
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL HAROUTUNIAN
Credential	:	D.O.
Telephone Number	:	313-291-4444

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	05/22/2008

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