Provider Demographics
NPI:1114974912
Name:QUALITY CARE PHYSICIANS GROUP
Entity Type:Organization
Organization Name:QUALITY CARE PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP HEAD
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-666-9000
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446
Mailing Address - Country:US
Mailing Address - Phone:866-898-7139
Mailing Address - Fax:616-975-9827
Practice Address - Street 1:1305 N OAKLAND BLVD
Practice Address - Street 2:ER DEPARTMENT
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327
Practice Address - Country:US
Practice Address - Phone:248-666-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207P00000X
MI363A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F375720OtherBCBS
CG4909OtherRR
0M92460Medicare PIN