Provider Demographics
NPI:1144468034
Name:ALEXANDER C BATCHEV DO PC
Entity type:Organization
Organization Name:ALEXANDER C BATCHEV DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMOEKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-362-1200
Mailing Address - Street 1:5400 FORT ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-4632
Mailing Address - Country:US
Mailing Address - Phone:734-362-1200
Mailing Address - Fax:734-362-1203
Practice Address - Street 1:5400 FORT ST
Practice Address - Street 2:SUITE 130
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-4632
Practice Address - Country:US
Practice Address - Phone:734-362-1200
Practice Address - Fax:734-362-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012210207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1658204654OtherBCBS OF MI
MI4276554Medicaid
MIG55502OtherHAP
MIG55502Medicare UPIN
MI4276554Medicaid