Provider Demographics
NPI:1831234269
Name:MICHIGAN EAR HEAD & NECK CLINIC PC
Entity type:Organization
Organization Name:MICHIGAN EAR HEAD & NECK CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVALIERE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-651-5051
Mailing Address - Street 1:811 OAKWOOD DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1360
Mailing Address - Country:US
Mailing Address - Phone:248-651-5051
Mailing Address - Fax:248-651-5053
Practice Address - Street 1:811 OAKWOOD DR
Practice Address - Street 2:SUITE 301
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1360
Practice Address - Country:US
Practice Address - Phone:248-651-5051
Practice Address - Fax:248-651-5053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P29850Medicare ID - Type Unspecified