Provider Demographics
NPI:1003936741
Name:MCG PROFESSIONAL BILLING L.L.C.
Entity Type:Organization
Organization Name:MCG PROFESSIONAL BILLING L.L.C.
Other - Org Name:WOMENS HEALTH ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:CORP DIRECTOR PHYSICIAN BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-342-1530
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:36500 S GRATIOT AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-1772
Practice Address - Country:US
Practice Address - Phone:586-493-3740
Practice Address - Fax:586-493-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M95100Medicare ID - Type UnspecifiedMEDICARE