Basic Information
| Provider Information | |||||||||
| NPI: | 1366825986 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EAST MICHIGAN HOSPITALISTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1217 KEARNEY ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | PORT HURON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480603571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109908302 | ||||||||
| FaxNumber: | 8109908402 | ||||||||
| Practice Location | |||||||||
| Address1: | 1217 KEARNEY ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | PORT HURON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480603571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109908302 | ||||||||
| FaxNumber: | 8109908402 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2015 | ||||||||
| LastUpdateDate: | 07/01/2015 | ||||||||
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| AuthorizedOfficialLastName: | KUMAR | ||||||||
| AuthorizedOfficialFirstName: | PONON | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5862609616 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.