Provider Demographics
NPI:1194806745
Name:BICOUNTY MEDICAL PRACTICES
Entity type:Organization
Organization Name:BICOUNTY MEDICAL PRACTICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLOMINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-558-5237
Mailing Address - Street 1:30205 SCHOENHERR RD STE B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6800
Mailing Address - Country:US
Mailing Address - Phone:586-558-9966
Mailing Address - Fax:586-558-5534
Practice Address - Street 1:30205 SCHOENHERR RD STE B
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6800
Practice Address - Country:US
Practice Address - Phone:586-558-9966
Practice Address - Fax:586-558-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty