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General NPI Number Information
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NPI Number | 1023048345
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Entity Type | Organization
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Legal Business Name | MICHIGAN CANCER SPECIALISTS, PLC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 18223 E 10 MILE RD SUITE 100
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City | ROSEVILLE
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State | MI
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Zip | 48066-5821
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Country | US
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Telephone | 586-778-5880
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Fax | 586-778-4362
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Provider Business Mailing Address
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Address Line | 18223 E 10 MILE RD SUITE 100
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City | ROSEVILLE
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State | MI
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Zip | 48066-5821
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Country | US
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Telephone | 586-778-5880
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Fax | 586-778-4362
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Authorized Official
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Title or Position | OWNER
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Name | DR. EUGENE J AGNONE
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Credential | M.D.
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Telephone | 586-778-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | EA036516
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License Number State | MI
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