Provider Demographics
NPI:1396135927
Name:COMPREHENSIVE MEDICAL CARE PC
Entity type:Organization
Organization Name:COMPREHENSIVE MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RAAKESH
Authorized Official - Middle Name:CHANDRA
Authorized Official - Last Name:BHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-441-1000
Mailing Address - Street 1:3600 CAPITAL AVE SW
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-9393
Mailing Address - Country:US
Mailing Address - Phone:269-441-1000
Mailing Address - Fax:269-441-1002
Practice Address - Street 1:3600 CAPITAL AVE SW
Practice Address - Street 2:SUITE 204
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9393
Practice Address - Country:US
Practice Address - Phone:269-441-1000
Practice Address - Fax:269-441-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048458207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2792609Medicaid
MIOM76510002OtherMEDICARE ID-TYPE UNSPECIFIED
MIA76272Medicare UPIN
MI2792609Medicaid