Provider Demographics
NPI:1104097468
Name:MEDICINE CONSULTATION SERVICES, INC
Entity type:Organization
Organization Name:MEDICINE CONSULTATION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCYLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:STIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-712-3456
Mailing Address - Street 1:PO BOX 130087
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48113-0087
Mailing Address - Country:US
Mailing Address - Phone:734-712-3456
Mailing Address - Fax:
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1014
Practice Address - Country:US
Practice Address - Phone:734-712-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3115020Medicaid
MI0811300Medicare PIN
MIF48170Medicare UPIN