Provider Demographics
NPI:1811947559
Name:HEALTH MANAGEMENT CONSULTANTS II PC
Entity type:Organization
Organization Name:HEALTH MANAGEMENT CONSULTANTS II PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-694-4134
Mailing Address - Street 1:6910 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-6912
Mailing Address - Country:US
Mailing Address - Phone:517-694-4134
Mailing Address - Fax:517-694-1629
Practice Address - Street 1:6910 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-6912
Practice Address - Country:US
Practice Address - Phone:517-694-4134
Practice Address - Fax:517-694-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDP008207207Q00000X, 208D00000X
MIKC046039207Q00000X, 208D00000X
MIBM009760207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3057787Medicaid
MI0103307202OtherDR. CONNELL BCN
MI700C361780OtherGROUP BCN
MI700C361780OtherGROUP BCBS
MI3057787Medicaid
MIB48991Medicare UPIN
MI700C361780OtherGROUP BCBS