Provider Demographics
NPI:1053484048
Name:EAR NOSE AND THROAT CONSULTANTS PC
Entity Type:Organization
Organization Name:EAR NOSE AND THROAT CONSULTANTS PC
Other - Org Name:QUALITY HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEINGARTEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:248-569-5985
Mailing Address - Street 1:29201 TELEGRAPH RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1331
Mailing Address - Country:US
Mailing Address - Phone:248-569-5985
Mailing Address - Fax:248-569-3704
Practice Address - Street 1:29201 TELEGRAPH RD
Practice Address - Street 2:SUITE 500
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1331
Practice Address - Country:US
Practice Address - Phone:248-569-5985
Practice Address - Fax:248-569-3704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJW051052174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N92790Medicare PIN