Provider Demographics
NPI:1982098646
Name:MICHIGAN HEALTHCARE PROFESSIONALS PC
Entity Type:Organization
Organization Name:MICHIGAN HEALTHCARE PROFESSIONALS PC
Other - Org Name:MILLENNIUM SLEEP CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST SECRETARY OF CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHAELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-851-1430
Mailing Address - Street 1:29992 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-851-1430
Mailing Address - Fax:248-851-5182
Practice Address - Street 1:32255 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 50
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1566
Practice Address - Country:US
Practice Address - Phone:248-945-0000
Practice Address - Fax:248-419-3506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic