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General NPI Number Information
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NPI Number | 1912191685
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Entity Type | Organization
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Legal Business Name | MACOMB COUNTY HEALTH DEPARTMENT
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 10/27/2007
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Provider Practice Location Address
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Address Line | 27690 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48093-2842
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Country | US
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Telephone | 586-465-9152
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Fax | 586-573-2378
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Provider Business Mailing Address
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Address Line | 43525 ELIZABETH RD
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043
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Country | US
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Telephone | 586-469-5235
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Fax | 586-469-5885
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Authorized Official
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Title or Position | DIRECTOR/HEALTH OFFICER
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Name | MR. THOMAS J. KALKOFEN IV
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Credential | M.P.H.
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Telephone | 586-469-5512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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