Healthcare Provider Details

I. General information

NPI: 1417215088
Provider Name (Legal Business Name): CDM CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22150 GREENFIELD RD STE 205
OAK PARK MI
48237-2535
US

IV. Provider business mailing address

22150 GREENFIELD RD STE 205
OAK PARK MI
48237-2535
US

V. Phone/Fax

Practice location:
  • Phone: 248-291-5801
  • Fax: 248-291-5808
Mailing address:
  • Phone: 248-291-5801
  • Fax: 248-291-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. CORINA MALONE
Title or Position: OWNER/OPERATOR
Credential:
Phone: 248-291-5805