Provider Demographics
NPI:1780717181
Name:MICHIGAN LUNG & SLEEP SPECIALISTS, PLC
Entity type:Organization
Organization Name:MICHIGAN LUNG & SLEEP SPECIALISTS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:VILLENEUVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-542-4470
Mailing Address - Street 1:14555 LEVAN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5085
Mailing Address - Country:US
Mailing Address - Phone:734-542-4470
Mailing Address - Fax:734-542-4475
Practice Address - Street 1:14555 LEVAN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:734-542-4470
Practice Address - Fax:734-542-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0200X, 207RS0012X
MI4301052792207RP1001X
MI4301057166207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF81559Medicare UPIN
MIF81558Medicare UPIN
MIOM99620Medicare ID - Type Unspecified