Basic Information
| Provider Information | |||||||||
| NPI: | 1568575215 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHIGAN EAR INSTITUTE PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30055 NORTHWESTERN HWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483343230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488654444 | ||||||||
| FaxNumber: | 2488656161 | ||||||||
| Practice Location | |||||||||
| Address1: | 30055 NORTHWESTERN HWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483343230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488654444 | ||||||||
| FaxNumber: | 2488656161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 01/11/2019 | ||||||||
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| AuthorizedOfficialLastName: | BABU | ||||||||
| AuthorizedOfficialFirstName: | SEILESH | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2488654135 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YX0901X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology | Otology & Neurotology | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 207Y00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.