Provider Demographics
NPI:1720418585
Name:AFEINSTEIN OMM INSTITUTE
Entity Type:Organization
Organization Name:AFEINSTEIN OMM INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:GREGG
Authorized Official - Last Name:FEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-840-7599
Mailing Address - Street 1:36397 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035
Mailing Address - Country:US
Mailing Address - Phone:586-840-7599
Mailing Address - Fax:586-840-7597
Practice Address - Street 1:37040 GARFIELD RD STE C-2
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3646
Practice Address - Country:US
Practice Address - Phone:586-840-7599
Practice Address - Fax:586-840-7597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
204D00000X
MI5101017208204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty