Provider Demographics
NPI:1619112653
Name:TRAVELING MEDICAL SERVICES II PC
Entity Type:Organization
Organization Name:TRAVELING MEDICAL SERVICES II PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-569-2695
Mailing Address - Street 1:17515 W 9 MILE RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4403
Mailing Address - Country:US
Mailing Address - Phone:248-569-2695
Mailing Address - Fax:858-366-9618
Practice Address - Street 1:17515 W 9 MILE RD
Practice Address - Street 2:SUITE 340
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4403
Practice Address - Country:US
Practice Address - Phone:248-569-2695
Practice Address - Fax:858-366-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty