Provider Demographics
NPI:1144396888
Name:HOWARD MEDICAL CLINIC
Entity Type:Organization
Organization Name:HOWARD MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HILLS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:313-863-8300
Mailing Address - Street 1:6001 W OUTER DR
Mailing Address - Street 2:SUITE 137
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2614
Mailing Address - Country:US
Mailing Address - Phone:313-863-8300
Mailing Address - Fax:
Practice Address - Street 1:6001 W OUTER DR
Practice Address - Street 2:SUITE 137
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2614
Practice Address - Country:US
Practice Address - Phone:313-863-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHH036546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA73635OtherOMNICARE HEALTH PLAN