Provider Demographics
NPI:1174698336
Name:MEDICAL REHABILITATION PHYSICIANS PLC
Entity type:Organization
Organization Name:MEDICAL REHABILITATION PHYSICIANS PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:BLEIBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-772-1609
Mailing Address - Street 1:2935 HEALTH PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858
Mailing Address - Country:US
Mailing Address - Phone:989-772-1609
Mailing Address - Fax:989-773-6279
Practice Address - Street 1:2935 HEALTH PARKWAY
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-772-1609
Practice Address - Fax:989-773-6279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X
MIMB009073111N00000X
MIMB064477332B00000X, 2084P0800X, 332B00000X, 2084P0800X
MIHR0774962084P0800X
MIRS005296363A00000X
MIGA191163363L00000X
MIJS111871363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1174698336Medicaid
MI0N95180Medicare PIN
T41353Medicare UPIN
H43129Medicare UPIN
Q67366Medicare UPIN
MI0N95180Medicare PIN
I44360Medicare UPIN
P82773Medicare UPIN
F87848Medicare UPIN
P43166Medicare UPIN