Provider Demographics
NPI:1073508255
Name:EAST CENTRAL ONCOLOGY ASSOCIATES PLC
Entity Type:Organization
Organization Name:EAST CENTRAL ONCOLOGY ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:HURTUBISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-631-3975
Mailing Address - Street 1:4011 ORCHARD DR
Mailing Address - Street 2:STE 1000
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6160
Mailing Address - Country:US
Mailing Address - Phone:989-631-3975
Mailing Address - Fax:989-631-4844
Practice Address - Street 1:4011 ORCHARD DR
Practice Address - Street 2:STE 1000
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6190
Practice Address - Country:US
Practice Address - Phone:989-631-3975
Practice Address - Fax:989-631-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301041385207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIC14732OtherPALMETTO GBA RAILROAD MEDICARE
MI0298330001OtherNATIONAL GOVERNMENT SERVICES INC
MI3523721Medicaid
MI0298330001Medicare NSC
MIC14732OtherPALMETTO GBA RAILROAD MEDICARE
MIB42914Medicare UPIN