1598711509 NPI number — CHERRY HILL INTERNAL MEDICINE ASSOCIATES PLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598711509 NPI number — CHERRY HILL INTERNAL MEDICINE ASSOCIATES PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHERRY HILL INTERNAL MEDICINE ASSOCIATES PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598711509
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2050 N HAGGERTY RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48187-3795
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-981-1086
Provider Business Mailing Address Fax Number:
734-981-2259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2050 N HAGGERTY RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48187-3795
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-981-1086
Provider Business Practice Location Address Fax Number:
734-981-2259
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHAEFFER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
STEVEN
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
734-981-1086

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CJ7507 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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