Provider Demographics
NPI:1225401599
Name:MICHIGAN SLEEP SOCIETY & RESEARCH CENTER, LLC
Entity Type:Organization
Organization Name:MICHIGAN SLEEP SOCIETY & RESEARCH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SOMMER
Authorized Official - Middle Name:CAMILLE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:810-733-8338
Mailing Address - Street 1:G3285 BEECHER RD
Mailing Address - Street 2:SUITE M
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3615
Mailing Address - Country:US
Mailing Address - Phone:810-733-8338
Mailing Address - Fax:810-733-8023
Practice Address - Street 1:G3285 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3615
Practice Address - Country:US
Practice Address - Phone:810-874-8384
Practice Address - Fax:810-733-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE7374T173F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty