Organization
FARMBROOK INTERNAL MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH N. HAGEN D.O. (PRESIDENT)
(248) 593-0575
Entity
Organization
Contact information
Practice address
31500 TELEGRAPH RD, SUITE 130, BINGHAM FARMS, MI 48025-4313
(248) 593-0575
(248) 433-3452
Mailing address
31500 TELEGRAPH RD, SUITE 130, BINGHAM FARMS, MI 48025-4313
(248) 593-0575
(248) 433-3452
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5101012230
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199809
—
MI
01
—
5631503
BCBSM PROVIDER CODE
MI
01
—
G25356
BLUE CROSS UPIN
MI
Enumeration date
09/16/2008
Last updated
11/01/2013
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