Provider Demographics
NPI:1932271061
Name:HEMATOLOGY ONCOLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MESSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-288-4500
Mailing Address - Street 1:3577 W 13 MILE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6710
Mailing Address - Country:US
Mailing Address - Phone:248-288-4500
Mailing Address - Fax:248-288-0450
Practice Address - Street 1:3577 W 13 MILE RD STE 103
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-288-4500
Practice Address - Fax:248-288-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI032480001OtherDME PTAN
MI032480001OtherDME PTAN