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NPI Code Detail

MEDICARE: MICHIGAN CONSULTING AND DIAGNOSTICS LLC

MEDICARE: MICHIGAN CONSULTING AND DIAGNOSTICS LLC
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
1208200000XPlastic Surgery Physician4301072477MI

General Provider Information

NPI Number : 1538491790
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHIGAN CONSULTING AND DIAGNOSTICS LLC
Provider Business Mailing Address
First Line : 390 ENTERPRISE CT STE 100
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-0320
Country : US
Telephone Number : 248-712-6030
Fax Number : 248-291-8753
Provider Business Practice Location Address
First Line : 390 ENTERPRISE CT STE 100
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-0320
Country : US
Telephone Number : 248-712-6030
Fax Number : 248-291-8753
Authorized Official
Title or Position : CARE COORDINATION DIRECTOR
Name : MRS. JAMIE MARTIN
Credential :
Telephone Number : 248-712-6030
Provider Enumeration Date : 02/12/2010
Last Update Date : 12/08/2014

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Directions to “MICHIGAN CONSULTING AND DIAGNOSTICS LLC ” Practice Location

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