Provider Demographics
NPI:1518000223
Name:GENERAL HOSP MEDICAL ASSOC, P.C.
Entity Type:Organization
Organization Name:GENERAL HOSP MEDICAL ASSOC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:KAZMIERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-468-8500
Mailing Address - Street 1:1030 HARRINGTON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2967
Mailing Address - Country:US
Mailing Address - Phone:586-468-8500
Mailing Address - Fax:586-468-7997
Practice Address - Street 1:1030 HARRINGTON ST STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2967
Practice Address - Country:US
Practice Address - Phone:586-468-8500
Practice Address - Fax:586-468-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M08290Medicare ID - Type UnspecifiedGROUP #