Provider Demographics
NPI:1376964411
Name:MICHIGAN HEALTHCARE PROFESSIONALS, P.C.
Entity Type:Organization
Organization Name:MICHIGAN HEALTHCARE PROFESSIONALS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-851-2446
Mailing Address - Street 1:29992 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-851-1430
Mailing Address - Fax:248-851-5182
Practice Address - Street 1:32255 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1566
Practice Address - Country:US
Practice Address - Phone:248-647-1100
Practice Address - Fax:248-945-1819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540H712140OtherBLUE SHIELD
MI6656600010Medicare NSC