Provider Demographics
NPI:1063500726
Name:PROFESSIONAL HEARING AID CENTER
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:DJ
Authorized Official - Last Name:MEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-779-2400
Mailing Address - Street 1:1 ALGER PL
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1908
Mailing Address - Country:US
Mailing Address - Phone:313-343-0267
Mailing Address - Fax:
Practice Address - Street 1:21518 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2211
Practice Address - Country:US
Practice Address - Phone:586-779-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA540E00292OtherBLUE SHIELD
MI640E07684OtherBLUE SHIELD