Provider Demographics
NPI:1740496702
Name:TANIR MEDICAL CENTER PC
Entity type:Organization
Organization Name:TANIR MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANIR AVCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-620-3700
Mailing Address - Street 1:6080 DIXIE HWY STE B
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-3493
Mailing Address - Country:US
Mailing Address - Phone:248-620-3700
Mailing Address - Fax:248-620-0228
Practice Address - Street 1:6080 DIXIE HWY STE B
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-3493
Practice Address - Country:US
Practice Address - Phone:248-620-3700
Practice Address - Fax:248-620-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060849261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIG25048Medicare UPIN