| Michael T King Llc | |
|
2111 University Park Dr Ste 400 Okemos MI 48864-6907 | |
| (517) 575-7823 | |
| Not Available |
| Full Name | Michael T King Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2111 University Park Dr Ste 400, Okemos, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael T King Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Michael T King Llc 2111 University Park Dr Ste 400 Okemos MI 48864-6907 Ph: (517) 575-7823 |
| NPI Number | 1578275657 |
|---|---|
| Provider Enumeration Date | 12/20/2022 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Medicare PECOS PAC ID | 0143690552 |
|---|---|
| Medicare Enrollment ID | O20221229001919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578275657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Michael T King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750996021 PECOS PAC ID: 1052781465 Enrollment ID: I20221229001983 |
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