Healthcare Provider Details

I. General information

NPI: 1992784102
Provider Name (Legal Business Name): BIRMINGHAM BLOOMFIELD AUDIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 W MAPLE RD STE. C
BLOOMFIELD HILLS MI
48301-3308
US

IV. Provider business mailing address

3500 W MAPLE RD STE. C
BLOOMFIELD HILLS MI
48301-3308
US

V. Phone/Fax

Practice location:
  • Phone: 248-203-9760
  • Fax: 204-203-6690
Mailing address:
  • Phone: 248-203-9760
  • Fax: 204-203-6690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTIN A HINDERLITER
Title or Position: DOCTOR OF AUDIOLOGY
Credential: AU.D.
Phone: 248-203-9760