Provider Demographics
NPI:1316116726
Name:HEMATOLOGY-ONCOLOGY ASSOC. EAST, PC
Entity type:Organization
Organization Name:HEMATOLOGY-ONCOLOGY ASSOC. EAST, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MOLLI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-884-1059
Mailing Address - Street 1:19229 MACK AVE
Mailing Address - Street 2:SUITE 24
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2858
Mailing Address - Country:US
Mailing Address - Phone:313-884-5522
Mailing Address - Fax:313-884-5521
Practice Address - Street 1:11051 HALL RD
Practice Address - Street 2:SUITE 120
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5735
Practice Address - Country:US
Practice Address - Phone:586-991-0700
Practice Address - Fax:586-991-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M31480Medicare PIN