Provider Demographics
NPI:1699818617
Name:TRUECARE ASTHMA AND ALLERGY CENTER
Entity Type:Organization
Organization Name:TRUECARE ASTHMA AND ALLERGY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TRUEHEART
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:248-395-2273
Mailing Address - Street 1:21700 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 835
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4906
Mailing Address - Country:US
Mailing Address - Phone:248-395-2273
Mailing Address - Fax:248-395-3889
Practice Address - Street 1:21700 NORTHWESTERN HIGHWAY
Practice Address - Street 2:SUITE 835
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4902
Practice Address - Country:US
Practice Address - Phone:248-395-2273
Practice Address - Fax:248-395-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301049422207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4628030Medicaid
MI4628030Medicaid
MI0P00260001Medicare PIN
MI0P00260Medicare PIN