Provider Demographics
NPI:1316968191
Name:MICHIGAN EMERGENCY SERVICES
Entity type:Organization
Organization Name:MICHIGAN EMERGENCY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PADRAIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWEENY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-745-3330
Mailing Address - Street 1:4201 SAINT ANTOINE ST
Mailing Address - Street 2:SUITE 3R
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:SUITE 3R
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical ToxicologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H21055OtherBCBS OF MICHIGAN
MI0M16430Medicare ID - Type Unspecified
MI0H21055OtherBCBS OF MICHIGAN