Provider Demographics
NPI:1306010673
Name:COMMUNITY SUPPORTED ANTHROPOSOPHICAL MEDICINE
Entity Type:Organization
Organization Name:COMMUNITY SUPPORTED ANTHROPOSOPHICAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCMULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-222-1491
Mailing Address - Street 1:1825 W STADIUM BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4501
Mailing Address - Country:US
Mailing Address - Phone:734-222-1491
Mailing Address - Fax:734-222-1492
Practice Address - Street 1:1825 W STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4501
Practice Address - Country:US
Practice Address - Phone:734-222-1491
Practice Address - Fax:734-222-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty