Provider Demographics
NPI:1548701014
Name:MI MED INC
Entity type:Organization
Organization Name:MI MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGROFF
Authorized Official - Suffix:
Authorized Official - Credentials:COF
Authorized Official - Phone:248-648-0675
Mailing Address - Street 1:7688 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1409
Mailing Address - Country:US
Mailing Address - Phone:248-648-0675
Mailing Address - Fax:248-599-7710
Practice Address - Street 1:7688 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1409
Practice Address - Country:US
Practice Address - Phone:248-648-0675
Practice Address - Fax:248-599-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier