Healthcare Provider Details

I. General information

NPI: 1386828150
Provider Name (Legal Business Name): HEARING CONSULTANTS OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28111 HOOVER RD STE 4
WARREN MI
48093-4153
US

IV. Provider business mailing address

28111 HOOVER RD STE 4
WARREN MI
48093-4153
US

V. Phone/Fax

Practice location:
  • Phone: 586-558-7477
  • Fax: 586-558-7479
Mailing address:
  • Phone: 586-558-7477
  • Fax: 586-558-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: DAWN M SKIDMORE
Title or Position: OFFICE MANAGER
Credential:
Phone: 586-558-7477