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NPI Code Detail

MEDICARE: COMPREHENSIVE MEDICAL GROUP PC

MEDICARE: COMPREHENSIVE MEDICAL GROUP PC
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
1207R00000XInternal Medicine Physician4301023744MI

General Provider Information

NPI Number : 1588945091
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE MEDICAL GROUP PC
Provider Business Mailing Address
First Line : 3499 S LINDEN RD
Second Line : SUITE 2
City : FLINT
State : MI
Zip : 48507-3022
Country : US
Telephone Number : 810-720-5715
Fax Number : 810-732-0891
Provider Business Practice Location Address
First Line : 3499 S LINDEN RD
Second Line : SUITE 2
City : FLINT
State : MI
Zip : 48507-3022
Country : US
Telephone Number : 810-820-8121
Fax Number : 810-820-8335
Authorized Official
Title or Position : OWNER
Name : EUGENE CHARDOUL
Credential : MD
Telephone Number : 810-720-5715
Provider Enumeration Date : 08/30/2011
Last Update Date : 08/30/2011

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Directions to “COMPREHENSIVE MEDICAL GROUP PC ” Practice Location

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