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General NPI Number Information
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NPI Number | 1982098646
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Entity Type | Organization
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Legal Business Name | MICHIGAN HEALTHCARE PROFESSIONALS PC
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 32255 NORTHWESTERN HWY SUITE 50
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-1566
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Country | US
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Telephone | 248-945-0000
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Fax | 248-419-3506
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Provider Business Mailing Address
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Address Line | 29992 NORTHWESTERN HWY SUITE 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 | 248-851-5182
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Authorized Official
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Title or Position | ASST SECRETARY OF CREDENTIALING
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Name | MS. MICHAELENE GOGOLIN
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Credential |
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Telephone | 248-851-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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