Provider Demographics
NPI:1760657605
Name:TROY MEDICAL CENTER MANAGEMENT
Entity Type:Organization
Organization Name:TROY MEDICAL CENTER MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABELARDO
Authorized Official - Middle Name:G
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-689-7100
Mailing Address - Street 1:1663 STEPHENSON HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-2169
Mailing Address - Country:US
Mailing Address - Phone:248-689-7100
Mailing Address - Fax:248-689-5571
Practice Address - Street 1:1663 STEPHENSON HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-2169
Practice Address - Country:US
Practice Address - Phone:248-689-7100
Practice Address - Fax:248-689-5571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center