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NPI Code Detail

MEDICARE: MICHIGAN INSTITUTE FOR HEALTH ENHANCEMENT

MEDICARE: MICHIGAN INSTITUTE FOR HEALTH ENHANCEMENT
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
1133NN1002XNutrition Education Nutritionist
2133NN1002XNutrition Education Nutritionist850328IL

General Provider Information

NPI Number : 1861489502
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHIGAN INSTITUTE FOR HEALTH ENHANCEMENT
Provider Business Mailing Address
First Line : 4986 N. ADAMS RD.
Second Line : SUITE D
City : ROCHESTER
State : MI
Zip : 48306-1416
Country : US
Telephone Number : 248-475-4880
Fax Number : 248-475-5777
Provider Business Practice Location Address
First Line : 4986 N. ADAMS RD.
Second Line : SUITE D
City : ROCHESTER
State : MI
Zip : 48306-1416
Country : US
Telephone Number : 248-475-4880
Fax Number : 248-475-5777
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. ALGIRDAS ANTANAS JUOCYS
Credential : D.O.
Telephone Number : 248-475-4702
Provider Enumeration Date : 09/27/2005
Last Update Date : 08/31/2012

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Directions to “MICHIGAN INSTITUTE FOR HEALTH ENHANCEMENT ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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