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General NPI Number Information
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NPI Number | 1932825668
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Entity Type | Organization
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Legal Business Name | MICHIGAN CARE MANAGEMENT SOLUTIONS LLC
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 24124 GREENFIELD RD STE 306
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City | SOUTHFIELD
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State | MI
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Zip | 48075
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Country | US
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Telephone | 313-348-0607
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Fax | 313-447-3705
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Provider Business Mailing Address
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Address Line | 1800 IROQUOIS ST
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City | DETROIT
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State | MI
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Zip | 48214-2748
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Country | US
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Telephone | 248-894-8905
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KIMBERLY SULLIVAN
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Credential |
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Telephone | 248-894-8905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SC2300X
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Taxonomy Name | Chronic Care Clinical Nurse Specialist
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License Number |
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License Number State |
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