Provider Demographics
NPI:1225225501
Name:INTERNAL MEDICINE CONSULTANTS, PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KULHANEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-732-0026
Mailing Address - Street 1:1409 S GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3538
Mailing Address - Country:US
Mailing Address - Phone:810-732-0026
Mailing Address - Fax:810-732-0029
Practice Address - Street 1:1409 S GRAHAM RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3538
Practice Address - Country:US
Practice Address - Phone:810-732-0026
Practice Address - Fax:810-732-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301049294207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOB56098Medicare PIN