Provider Demographics
NPI:1033575030
Name:CONCERTO MEDICAL GROUP OF MICHIGAN, P.C.
Entity Type:Organization
Organization Name:CONCERTO MEDICAL GROUP OF MICHIGAN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-748-4200
Mailing Address - Street 1:PO BOX 809393
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-9393
Mailing Address - Country:US
Mailing Address - Phone:313-748-4200
Mailing Address - Fax:
Practice Address - Street 1:7430 2ND AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2739
Practice Address - Country:US
Practice Address - Phone:313-748-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty