Healthcare Provider Details

I. General information

NPI: 1114600558
Provider Name (Legal Business Name): MEDICAL CARE INNOVATION, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12334 GEDDES ROAD
HEMLOCK MI
48626
US

IV. Provider business mailing address

W227N6103 SUSSEX RD
SUSSEX WI
53089-3969
US

V. Phone/Fax

Practice location:
  • Phone: 989-642-0045
  • Fax: 414-622-3878
Mailing address:
  • Phone: 414-566-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFERSON HARMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 414-566-8400