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NPI Code Detail

MEDICARE: INTERNAL MEDICINE ASSOCIATES, PC

MEDICARE: INTERNAL MEDICINE ASSOCIATES, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianIT053374MI

General Provider Information

NPI Number : 1649319526
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERNAL MEDICINE ASSOCIATES, PC
Provider Business Mailing Address
First Line : 5039 VILLA LINDE PKWY
Second Line : SUITE 31
City : FLINT
State : MI
Zip : 48532-3450
Country : US
Telephone Number : 810-733-5390
Fax Number : 810-733-6090
Provider Business Practice Location Address
First Line : 5039 VILLA LINDE PKWY
Second Line : SUITE 31
City : FLINT
State : MI
Zip : 48532-3450
Country : US
Telephone Number : 810-733-5390
Fax Number : 810-733-6090
Authorized Official
Title or Position : PRESIDENT
Name : IMAD TAHBOUB VI
Credential : M.D.
Telephone Number : 810-733-5390
Provider Enumeration Date : 02/06/2007
Last Update Date : 08/22/2020

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Directions to “INTERNAL MEDICINE ASSOCIATES, PC ” Practice Location

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