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General NPI Number Information
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NPI Number | 1407827900
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Entity Type | Organization
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Legal Business Name | SLEEP DIAGNOSTICS OF MICHIGAN PC
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 611 COURT STREET
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City | WEST BRANCH
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State | MI
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Zip | 48661
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Country | US
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Telephone | 989-516-4317
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Fax | 989-345-5803
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Provider Business Mailing Address
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Address Line | 611 COURT ST PO BOX 428
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City | WEST BRANCH
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State | MI
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Zip | 48661-9390
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Country | US
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Telephone | 989-516-4317
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Fax | 989-345-5803
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RICHARD WAYNE MACAULEY
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Credential | MD
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Telephone | 989-516-4317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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