Provider Demographics
NPI:1750466397
Name:AUBURN HILLS MEDICAL CLINIC PC
Entity type:Organization
Organization Name:AUBURN HILLS MEDICAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:K
Authorized Official - Last Name:THORBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-373-1790
Mailing Address - Street 1:3095 E WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2370
Mailing Address - Country:US
Mailing Address - Phone:248-373-1790
Mailing Address - Fax:248-373-3758
Practice Address - Street 1:3095 E WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2370
Practice Address - Country:US
Practice Address - Phone:248-373-1790
Practice Address - Fax:248-373-3758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P29940Medicare PIN