MEDICARE: PROGRESSIVE HEALTH CARE, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1285978528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE HEALTH CARE, P.C.

Provider Business Mailing Address
First Line	:	22021 ECORSE RD
Second Line	:
City	:	TAYLOR
State	:	MI
Zip	:	48180-1847
Country	:	US
Telephone Number	:	313-291-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	22021 ECORSE RD
Second Line	:
City	:	TAYLOR
State	:	MI
Zip	:	48180-1847
Country	:	US
Telephone Number	:	313-291-4444
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARMEN A. KORKIGIAN
Credential	:	DO
Telephone Number	:	313-291-4444

Provider Enumeration Date	:	11/26/2012
Last Update Date	:	11/26/2012

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