Organization
MEDICAL REHABILITATION PHYSICIANS
Active
Other names
Michigan Spine and Pain
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN N BLEIBERG MD (MEDICAL DIRECTOR)
(989) 772-1609
Entity
Organization
Contact information
Practice address
6079 W MAPLE RD, #100B, WEST BLOOMFIELD, MI 48322-2283
(248) 851-7246
(248) 851-7223
Mailing address
2480 W CAMPUS DR, STE 500, MOUNT PLEASANT, MI 48858-5414
(989) 772-1609
(989) 772-6279
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4704253934
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704253934
STATE LICENSE
MI
Enumeration date
10/24/2013
Last updated
10/24/2013
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