Provider Demographics
NPI:1053480939
Name:COMPREHENSIVE BREAST CENTERS
Entity Type:Organization
Organization Name:COMPREHENSIVE BREAST CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-677-8200
Mailing Address - Street 1:4012 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9505
Mailing Address - Country:US
Mailing Address - Phone:734-677-8200
Mailing Address - Fax:734-677-8296
Practice Address - Street 1:4012 CLARK RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9505
Practice Address - Country:US
Practice Address - Phone:734-677-8200
Practice Address - Fax:734-677-8296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty