Organization
NES MICHIGAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MOORE (CFO)
(415) 435-4591
Entity
Organization
Contact information
Practice address
718 N MACOMB ST, MONROE, MI 48162-7815
(734) 240-8400
Mailing address
PO BOX 636160, CINCINNATI, OH 45263-0001
(800) 377-8721
(304) 697-1155
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000773
—
OH
01
—
500E812430
BCBS - NP GROUP
MI
01
—
700E812320
BCBS
MI
01
—
CB6701
RR MEDICARE
—
Enumeration date
05/29/2008
Last updated
04/30/2013
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