Provider Demographics
NPI:1043204274
Name:FAMILY CARE PHYSICIANS, P.C.
Entity Type:Organization
Organization Name:FAMILY CARE PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SACK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-476-0035
Mailing Address - Street 1:39500 W. TEN MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375
Mailing Address - Country:US
Mailing Address - Phone:248-476-0035
Mailing Address - Fax:248-476-2418
Practice Address - Street 1:39500 W. TEN MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375
Practice Address - Country:US
Practice Address - Phone:248-476-0035
Practice Address - Fax:248-476-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1411744Medicaid
A76040Medicare UPIN
MI0M01150Medicare ID - Type Unspecified