Provider Demographics
NPI:1972765998
Name:ARTURO L MOJARES M.D. PC
Entity type:Organization
Organization Name:ARTURO L MOJARES M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ-MOJARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-649-1410
Mailing Address - Street 1:1575 W BIG BEAVER RD
Mailing Address - Street 2:BLDG C10
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3536
Mailing Address - Country:US
Mailing Address - Phone:248-649-1410
Mailing Address - Fax:248-649-7205
Practice Address - Street 1:1575 W BIG BEAVER RD
Practice Address - Street 2:BLDG C10
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3536
Practice Address - Country:US
Practice Address - Phone:248-649-1410
Practice Address - Fax:248-649-7205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
4301032030385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1050553Medicaid
MI1050553Medicaid