Provider Demographics
NPI:1801308788
Name:MICHIGAN ABILITIES CENTER PHYSICAL MEDICINE AND REHABILITATION PLLC
Entity type:Organization
Organization Name:MICHIGAN ABILITIES CENTER PHYSICAL MEDICINE AND REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:HINDERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-622-9500
Mailing Address - Street 1:7285 W ELLSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9277
Mailing Address - Country:US
Mailing Address - Phone:734-622-9500
Mailing Address - Fax:734-622-9555
Practice Address - Street 1:34020 7 MILE RD STE 102
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3093
Practice Address - Country:US
Practice Address - Phone:734-622-9500
Practice Address - Fax:734-622-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052044208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1619915782OtherNPI TYPE 1
MI4301052044Medicaid
1619915782OtherNPI TYPE 1