Provider Demographics
NPI:1225295660
Name:MCLAREN MEDICAL MANAGEMENT INC
Entity Type:Organization
Organization Name:MCLAREN MEDICAL MANAGEMENT INC
Other - Org Name:MCLAREN MEDICAL MANAGEMENT - CONVENIENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CORP DIRECTOR PHYSICIAN BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-342-1530
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:10090 E LIPPINCOTT BLVD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-9151
Practice Address - Country:US
Practice Address - Phone:810-658-6528
Practice Address - Fax:810-653-8589
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCLAREN MEDICAL MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty