Provider Demographics
NPI:1578333944
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:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGHTUM
Authorized Official - Middle Name:
Authorized Official - Last Name:HALSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-780-6615
Mailing Address - Street 1:29992 NORTHWESTERN HWY STE C
Mailing Address - Street 2:
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 1:1213 MASON ST STE 3
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2841
Practice Address - Country:US
Practice Address - Phone:313-278-2800
Practice Address - Fax:313-278-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment