Provider Demographics
NPI:1770676900
Name:MHNI SLEEP MEDICINE PC
Entity Type:Organization
Organization Name:MHNI SLEEP MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:F
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:734-677-6000
Mailing Address - Street 1:3120 PROFESSIONAL DR
Mailing Address - Street 2:SLEEP MEDICINE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5131
Mailing Address - Country:US
Mailing Address - Phone:734-677-6000
Mailing Address - Fax:734-677-2422
Practice Address - Street 1:3120 PROFESSIONAL DR
Practice Address - Street 2:SLEEP MEDICINE
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5131
Practice Address - Country:US
Practice Address - Phone:734-677-6000
Practice Address - Fax:734-677-2422
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHIGAN HEADACHE & NEUROLOGICAL INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ON74150Medicare ID - Type UnspecifiedSLEEP
MIOH74150Medicare PIN