Provider Demographics
NPI:1346332426
Name:MICHIGAN CORNEA CONSULTANTS PC
Entity Type:Organization
Organization Name:MICHIGAN CORNEA CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COMPANY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUBCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-207-1690
Mailing Address - Street 1:29201 TELEGRAPH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1331
Mailing Address - Country:US
Mailing Address - Phone:248-350-1130
Mailing Address - Fax:248-350-2709
Practice Address - Street 1:29201 TELEGRAPH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1331
Practice Address - Country:US
Practice Address - Phone:248-350-1130
Practice Address - Fax:248-350-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI180F319540OtherBCN
MI3277575Medicaid
MI1818756Medicaid
MI1806325501OtherSTEVEN DUNN BS
MI1806325521OtherDAVID HEIDEMANN BS
MI1806325541OtherCHRISTOPHER CHOW BS
MI1829787Medicaid
MIB44795Medicare UPIN
MIG28119Medicare UPIN
MI1829787Medicaid
MI1818756Medicaid