Vandyke Medical Clinic Management Corp in Detroit - Health Service
Vandyke Medical Clinic Management Corp - NPI 1174632087
Vandyke Medical Clinic Management Corp is a Health Service in Detroit, Michigan. Vandyke Medical Clinic Management Corp practices all healthcare services and medical treatments related to Health Service. The NPI Number for Vandyke Medical Clinic Management Corp is 1174632087. The last update date is 2015-12-01.
Vandyke Medical Clinic Management Corp's current location address is 19431 Van Dyke St, Detroit, Michigan. You can contact this provider via phone number 3138932010 and fax number 3138933308. The mailing address for Vandyke Medical Clinic Management Corp is 19431 Van Dyke St, Detroit, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Vandyke Medical Clinic Management Corp |
|---|---|
| Address | 19431 Van Dyke St, Detroit, Michigan |
| Phone Number | 3138932010 |
| Fax Number | 3138933308 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Mullen A Ernest |
| Credentials | M.D. |
| Telephone Number | 3138932010 |
NPI Number Detail
| NPI Number | 1174632087 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2015-12-01 |
Provider Mailing Address Detail
| Address | 19431 Van Dyke St |
|---|---|
| City | Detroit |
| State | Michigan (MI) |
| Post Code | 482343323 |
| Phone Number | 3138932010 |
| Fax Number | 3138933308 |
Provider's Primary Taxonomy Detail
| Speciality | Health Service |
|---|---|
| Taxonomy | 261Qh0100X |
| Licence No | 4301081357 |
|
Definition: Provides general outpatient medical care by physicians and other providers. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4796189 TYPE 10 | MI | -- | |
| 080H249740 | MI | BLUE CROSS GROUP PIN |
Post Comment/ Review Below
What is the Vandyke Medical Clinic Management Corp's 1174632087?
The Vandyke Medical Clinic Management Corp's NPI (National Provider Identifier) Number is 1174632087. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Vandyke Medical Clinic Management Corp's facilities are geographically located?
The facilities of Vandyke Medical Clinic Management Corp are physically situated at the following location: 19431 Van Dyke St, Detroit, MI, 482343323.
What is Vandyke Medical Clinic Management Corp's specialized field of practice, and what is the corresponding taxonomy classification code?
The Vandyke Medical Clinic Management Corp's area of specialization is Health Service, and the corresponding taxonomy code that categorizes this field of practice is 261Qh0100X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1174632087 to Vandyke Medical Clinic Management Corp?
The Centers for Medicare & Medicaid Services originally issued the 1174632087 to Vandyke Medical Clinic Management Corp on 2006-08-30.
As of what date was the information pertaining to Vandyke Medical Clinic Management Corp, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Vandyke Medical Clinic Management Corp, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2015-12-01.
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