Provider Demographics
NPI:1487841367
Name:MEDICAL MANAGEMENT SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:MEDICAL MANAGEMENT SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:O
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-746-0882
Mailing Address - Street 1:29829 TELEGRAPH RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1330
Mailing Address - Country:US
Mailing Address - Phone:248-357-0242
Mailing Address - Fax:248-357-0314
Practice Address - Street 1:29829 TELEGRAPH RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1330
Practice Address - Country:US
Practice Address - Phone:248-357-0242
Practice Address - Fax:248-357-0314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty