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General NPI Number Information
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NPI Number | 1568285872
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Entity Type | Organization
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Legal Business Name | MICHIGAN HEALTHCARE PROFESSIONALS, P.C.
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 16551 W WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48228-3706
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Country | US
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Telephone | 313-584-3624
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Fax | 313-584-8060
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Provider Business Mailing Address
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Address Line | 29992 NORTHWESTERN HWY STE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3292
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Country | US
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Telephone | 248-851-1430
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | AUGHTUM HALSEY
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Credential |
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Telephone | 248-780-6615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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