Basic Information
| Provider Information | |||||||||
| NPI: | 1013091990 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ASSOCIATED ENDOCRINOLOGISTS, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32255 NORTHWESTERN HWY STE 214 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483341573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488555620 | ||||||||
| FaxNumber: | 2488555628 | ||||||||
| Practice Location | |||||||||
| Address1: | 32255 NORTHWESTERN HWY STE 214 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483341573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488555620 | ||||||||
| FaxNumber: | 2488555628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | FILLION | ||||||||
| AuthorizedOfficialFirstName: | SANDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2488555620 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 110F376780 | 01 | MI | BCBS | OTHER |