Provider Demographics
NPI:1467158915
Name:MICHIGAN RHEUMATOLOGY AND WELLNESS CENTER
Entity Type:Organization
Organization Name:MICHIGAN RHEUMATOLOGY AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-923-1300
Mailing Address - Street 1:3950 S ROCHESTER RD STE 1300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5169
Mailing Address - Country:US
Mailing Address - Phone:248-923-1300
Mailing Address - Fax:248-218-1071
Practice Address - Street 1:3950 S ROCHESTER RD
Practice Address - Street 2:STE 1300
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5169
Practice Address - Country:US
Practice Address - Phone:248-923-1300
Practice Address - Fax:248-218-1071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1457458713OtherNPI
MI1902255532OtherNPI