Healthcare Provider Details

I. General information

NPI: 1265876403
Provider Name (Legal Business Name): MEDICAL BUSINESS CONSULTANTS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63474 ZABEL SHORES RD
STURGIS MI
49091-9371
US

IV. Provider business mailing address

63474 ZABEL SHORES RD
STURGIS MI
49091-9371
US

V. Phone/Fax

Practice location:
  • Phone: 708-805-8900
  • Fax:
Mailing address:
  • Phone: 708-805-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER J POLLACHEK
Title or Position: PRESIDENT
Credential:
Phone: 708-895-9450