Healthcare Provider Details

I. General information

NPI: 1689992208
Provider Name (Legal Business Name): NIGHT HAWK SLEEP SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15760 19 MILE RD SUITE F
CLINTON TOWNSHIP MI
48038-6319
US

IV. Provider business mailing address

15760 19 MILE RD SUITE F
CLINTON TOWNSHIP MI
48038-6319
US

V. Phone/Fax

Practice location:
  • Phone: 586-416-2550
  • Fax: 586-416-2580
Mailing address:
  • Phone: 586-416-2550
  • Fax: 586-416-2580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateMI

VIII. Authorized Official

Name: KAREN KATOPODES
Title or Position: OFFICE MANAGER
Credential:
Phone: 586-416-2550