Provider Demographics
NPI:1366754459
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/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
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:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858
Mailing Address - Country:US
Mailing Address - Phone:989-772-1609
Mailing Address - Fax:989-773-6778
Practice Address - Street 1:2935 HEALTH PARKWAY
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-772-1609
Practice Address - Fax:989-773-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMB064477332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6427070001Medicare NSC
MI0P13600Medicare PIN
MI0N95180Medicare PIN