MEDICARE: HOME MEDICAL CONSULTANTS PLLC

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	4301049534	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD049534	OTHER	MI	BCBSM LICENSE NUMBER

General Provider Information

NPI Number	:	1659421717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME MEDICAL CONSULTANTS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 251625
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48325-1625
Country	:	US
Telephone Number	:	586-431-0222
Fax Number	:	248-682-2783

Provider Business Practice Location Address
First Line	:	2972 ORCHARD PL
Second Line	:
City	:	ORCHARD LAKE
State	:	MI
Zip	:	48324-2360
Country	:	US
Telephone Number	:	586-431-0222
Fax Number	:	248-682-2783

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL CARL DAVIS
Credential	:	M.D.
Telephone Number	:	586-431-0222

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	01/24/2008

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