Provider Demographics
NPI:1427476431
Name:HEALTH HEROES OF MICHIGAN INC
Entity type:Organization
Organization Name:HEALTH HEROES OF MICHIGAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER-DI SALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-426-5389
Mailing Address - Street 1:2723 S STATE ST STE 150147
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6188
Mailing Address - Country:US
Mailing Address - Phone:334-558-5446
Mailing Address - Fax:
Practice Address - Street 1:2723 S STATE ST STE 150147
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6188
Practice Address - Country:US
Practice Address - Phone:334-558-5446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty