Provider Demographics
NPI:1679877211
Name:THE MEDICAL TEAM, INC.
Entity type:Organization
Organization Name:THE MEDICAL TEAM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-390-2300
Mailing Address - Street 1:4400 S SAGINAW ST STE 1300A
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2645
Mailing Address - Country:US
Mailing Address - Phone:810-239-3000
Mailing Address - Fax:810-239-3650
Practice Address - Street 1:5406 GATEWAY CTRE
Practice Address - Street 2:SUITE F
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3933
Practice Address - Country:US
Practice Address - Phone:810-239-3000
Practice Address - Fax:810-239-3650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WH1000X
MI1041000130251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID
MI=========OtherTAX ID