Provider Demographics
NPI:1487796504
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:MRS
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 1:6079 W. MAPLE RD.
Practice Address - Street 2:STE. 100B
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322
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:2007-02-13
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICC0877571041C0700X
MIMB009073111NR0400X
MIMB064477332B00000X, 174400000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1487796504Medicaid
MI0P13600Medicare PIN
MI1487796504Medicaid
MIU68655Medicare UPIN
MIU68655Medicare UPIN