1174609945 NPI number — MICHAEL S FINN PC

Table of content: (NPI 1174609945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174609945 NPI number — MICHAEL S FINN PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL S FINN PC
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:
1174609945
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1048
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NOVI
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48376-1048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-349-1740
Provider Business Mailing Address Fax Number:
248-349-1741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23985 NOVI RD
Provider Second Line Business Practice Location Address:
B-104
Provider Business Practice Location Address City Name:
NOVI
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48375-5436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-912-0080
Provider Business Practice Location Address Fax Number:
248-912-0208
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FINN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
SEAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
734-762-0701

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  6301006128 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 680H23041 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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