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General NPI Number Information
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NPI Number | 1245283365
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Entity Type | Organization
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Legal Business Name | RHEUMATOLOGY CONSULTING PC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 1115 S UNION ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-3258
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Country | US
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Telephone | 231-935-0550
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Fax | 231-935-0551
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Provider Business Mailing Address
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Address Line | PO BOX 728
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City | TRAVERSE CITY
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State | MI
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Zip | 49685-0728
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Country | US
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Telephone | 231-935-0550
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Fax | 231-935-0551
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MICHAEL L MAWBY
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Credential | MD
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Telephone | 231-935-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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