Provider Demographics
NPI:1205820461
Name:MICHIGAN BONE AND MINERAL CLINIC, P.C.
Entity Type:Organization
Organization Name:MICHIGAN BONE AND MINERAL CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-640-7700
Mailing Address - Street 1:22201 MOROSS RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2169
Mailing Address - Country:US
Mailing Address - Phone:313-640-7700
Mailing Address - Fax:313-640-1740
Practice Address - Street 1:22201 MOROSS RD
Practice Address - Street 2:SUITE 260
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2169
Practice Address - Country:US
Practice Address - Phone:313-640-7700
Practice Address - Fax:313-640-1740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty