Provider Demographics
NPI:1114632932
Name:ENT CARE OF MICHIGAN PLC
Entity Type:Organization
Organization Name:ENT CARE OF MICHIGAN PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SUCCAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-254-8900
Mailing Address - Street 1:5220 HIGHLAND RD STE 230
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1973
Mailing Address - Country:US
Mailing Address - Phone:248-254-8900
Mailing Address - Fax:248-599-7191
Practice Address - Street 1:5220 HIGHLAND RD STE 230
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1973
Practice Address - Country:US
Practice Address - Phone:248-254-8900
Practice Address - Fax:248-599-7191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty