Provider Demographics
NPI:1972614998
Name:BI-COUNTY MEDICAL PRACTICES
Entity Type:Organization
Organization Name:BI-COUNTY MEDICAL PRACTICES
Other - Org Name:BI-COUNTY GENERAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANCTIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-874-3436
Mailing Address - Street 1:26156 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015-2110
Mailing Address - Country:US
Mailing Address - Phone:313-874-3436
Mailing Address - Fax:
Practice Address - Street 1:26156 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-2110
Practice Address - Country:US
Practice Address - Phone:313-874-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013544208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty