MEDICARE: MICHIGAN COMPREHENSIVE MEDIC AL EVALUATIONS

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	174400000X	Specialist

General Provider Information

NPI Number	:	1669639647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN COMPREHENSIVE MEDIC AL EVALUATIONS

Provider Business Mailing Address
First Line	:	23700 ORCHARD LAKE RD STE A
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2559
Country	:	US
Telephone Number	:	248-442-9400
Fax Number	:	248-442-9403

Provider Business Practice Location Address
First Line	:	23700 ORCHARD LAKE RD STE A
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2559
Country	:	US
Telephone Number	:	248-442-9400
Fax Number	:	248-442-9403

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MICHELLE HYATT
Credential	:	OWNER
Telephone Number	:	248-442-9400

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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