Provider Demographics
NPI:1598858409
Name:CES CONSULTATION, P.C.
Entity Type:Organization
Organization Name:CES CONSULTATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:269-491-0030
Mailing Address - Street 1:601 32ND ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9150
Mailing Address - Country:US
Mailing Address - Phone:269-491-0030
Mailing Address - Fax:
Practice Address - Street 1:7320 GARDEN LN
Practice Address - Street 2:SUITE 110
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-4423
Practice Address - Country:US
Practice Address - Phone:269-491-0030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008147251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI680C94586OtherBCBS
MION63250Medicare ID - Type Unspecified