Healthcare Provider Details

I. General information

NPI: 1477049088
Provider Name (Legal Business Name): ROBERT CARTWRIGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19991 HALL RD STE 102
MACOMB TWP MI
48044
US

IV. Provider business mailing address

19991 HALL RD STE 102
MACOMB TWP MI
48044
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-4401
  • Fax: 586-263-4402
Mailing address:
  • Phone: 586-263-4401
  • Fax: 586-263-4402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3501006969
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: