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General NPI Number Information
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NPI Number | 1760660401
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Entity Type | Organization
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Legal Business Name | MSN HEALTHCARE
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 1715 W DEAN RD STE B
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City | TEMPERANCE
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State | MI
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Zip | 48182-9406
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Country | US
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Telephone | 734-847-4700
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Fax | 734-847-4711
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Provider Business Mailing Address
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Address Line | 1715 W DEAN RD STE B
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City | TEMPERANCE
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State | MI
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Zip | 48182-9406
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Country | US
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Telephone | 734-847-4700
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Fax | 734-847-4711
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK STEPHEN NEUMANN
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Credential | D.O.
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Telephone | 734-847-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 5101013724
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License Number State | MI
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