Provider Demographics
NPI:1528002540
Name:CANTON MEDICAL CARE CENTER,P.C.
Entity Type:Organization
Organization Name:CANTON MEDICAL CARE CENTER,P.C.
Other - Org Name:SAME AS ABOVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAILEN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:MUKERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-455-8222
Mailing Address - Street 1:7288-90 SHELDON ROAD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2150
Mailing Address - Country:US
Mailing Address - Phone:734-455-8222
Mailing Address - Fax:734-455-5222
Practice Address - Street 1:7288 N SHELDON RD
Practice Address - Street 2:7290 SHELDON ROAD
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2150
Practice Address - Country:US
Practice Address - Phone:734-455-8222
Practice Address - Fax:734-455-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center