Provider Demographics
NPI:1215654660
Name:CLINICAL RESEARCH INSTITUTE OF MICHIGAN, LLC
Entity type:Organization
Organization Name:CLINICAL RESEARCH INSTITUTE OF MICHIGAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-598-3329
Mailing Address - Street 1:30795 23 MILE RD
Mailing Address - Street 2:STE 206
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-5721
Mailing Address - Country:US
Mailing Address - Phone:586-598-3329
Mailing Address - Fax:586-948-1386
Practice Address - Street 1:30795 23 MILE RD
Practice Address - Street 2:STE 206
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-5721
Practice Address - Country:US
Practice Address - Phone:586-598-3329
Practice Address - Fax:586-948-1386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Multi-Specialty