Basic Information
Provider Information
NPI: 1841570991
EntityType: 2
ReplacementNPI:  
OrganizationName: MICHIGAN HEALTHCARE PROFESSIONALS PC
LastName:  
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MiddleName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 27301 DEQUINDRE
Address2: SUITE 314
City: MADISON HEIGHTS
State: MI
PostalCode: 480713459
CountryCode: US
TelephoneNumber: 2483994400
FaxNumber: 2483994840
Practice Location
Address1: 27900 GRAND RIVER AVE
Address2: SUITE 220
City: FARMINGTON HILLS
State: MI
PostalCode: 483365939
CountryCode: US
TelephoneNumber: 2484770552
FaxNumber: 2484770742
Other Information
ProviderEnumerationDate: 08/22/2011
LastUpdateDate: 02/04/2016
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: MARGOLIS
AuthorizedOfficialFirstName: JEFFREY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 2484770552
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


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