MEDICARE: COMPREHENSIVE HEMATOLOGY ONCOLOGY PHYSICIANS. P.C.

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	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1922075472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE HEMATOLOGY ONCOLOGY PHYSICIANS. P.C.

Provider Business Mailing Address
First Line	:	4900 MERCURY DR
Second Line	:	SUITE 100
City	:	DEARBORN
State	:	MI
Zip	:	48126-2947
Country	:	US
Telephone Number	:	313-271-9010
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 MERCURY DR
Second Line	:	SUITE 100
City	:	DEARBORN
State	:	MI
Zip	:	48126-2947
Country	:	US
Telephone Number	:	313-271-9010
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	TRUDY HALLAHAN
Credential	:
Telephone Number	:	313-271-9010

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	08/22/2020

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