Provider Demographics
NPI:1538559539
Name:CADILLAC AFTER HOURS CONTINUING CARE PLLC
Entity type:Organization
Organization Name:CADILLAC AFTER HOURS CONTINUING CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOORES
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:231-775-8814
Mailing Address - Street 1:440 COBB ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2542
Mailing Address - Country:US
Mailing Address - Phone:231-775-8814
Mailing Address - Fax:
Practice Address - Street 1:440 COBB ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2542
Practice Address - Country:US
Practice Address - Phone:231-775-8814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty