Provider Demographics
NPI:1245283365
Name:RHEUMATOLOGY CONSULTING PC
Entity type:Organization
Organization Name:RHEUMATOLOGY CONSULTING PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAWBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-935-0550
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-0728
Mailing Address - Country:US
Mailing Address - Phone:231-935-0550
Mailing Address - Fax:231-935-0551
Practice Address - Street 1:1115 S UNION ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-3258
Practice Address - Country:US
Practice Address - Phone:231-935-0550
Practice Address - Fax:231-935-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B81224OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI110B812240OtherBLUE CARE NETWORK
MI1386631455OtherMARIANNE PEACOCK FNP-BC
MI110B812240OtherBCBS GROUP PROVIDER #
MI0B81224OtherBLUE CROSS BLUE SHIELD FEDERAL EMPLOYEE PROGRAM
MI0B81224OtherBLUE CARE NETWORK
MI1245283365OtherARTHRITIS & OSTEOPOROSIS CENTER
MI1245283365OtherRHEUMATOLOGY CONSULTING PC
MI1245283365OtherRHEUMATOLOGY CONSULTING PC