Provider Demographics
NPI:1205967361
Name:MIDWEST CENTER FOR SLEEP DISORDERS
Entity type:Organization
Organization Name:MIDWEST CENTER FOR SLEEP DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-663-9469
Mailing Address - Street 1:101 E SPICERVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827-1919
Mailing Address - Country:US
Mailing Address - Phone:517-663-9469
Mailing Address - Fax:517-663-9470
Practice Address - Street 1:10415 GRAND RIVER RD
Practice Address - Street 2:STE 500
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-6533
Practice Address - Country:US
Practice Address - Phone:810-225-7595
Practice Address - Fax:810-225-7597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies