Provider Demographics
NPI:1174852404
Name:EDITH NEMETH, M.D. P.L.C.
Entity Type:Organization
Organization Name:EDITH NEMETH, M.D. P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NADAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-547-3914
Mailing Address - Street 1:7367 COGGERS MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8376
Mailing Address - Country:US
Mailing Address - Phone:734-417-0936
Mailing Address - Fax:
Practice Address - Street 1:136 KISSANE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-2467
Practice Address - Country:US
Practice Address - Phone:810-225-2331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3310769Medicaid
MI4301061656OtherSTATE LIC. NUMBER
MI0815043OtherBLUE CROSS OF MICHIGAN
MI0815043OtherBLUE CROSS OF MICHIGAN