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General NPI Number Information
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NPI Number | 1861800666
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Entity Type | Organization
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Legal Business Name | MICHIGAN CONTINUUM CARE PLLC
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 1310 GREENWOOD AVE.
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City | JACKSON
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State | MI
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Zip | 49203
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Country | US
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Telephone | 517-990-8149
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Fax | 517-990-0274
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Provider Business Mailing Address
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Address Line | 1310 GREENWOOD AVE
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City | JACKSON
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State | MI
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Zip | 49203
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Country | US
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Telephone | 517-990-8149
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Fax | 517-990-0274
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Authorized Official
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Title or Position | OWNER
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Name | DR. VLAD TUDOR MOTOC
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Credential | MD
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Telephone | 734-821-5699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301085310
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License Number State | MI
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