Healthcare Provider Details

I. General information

NPI: 1366505802
Provider Name (Legal Business Name): SPORTS MEDICINE ASSOCIATES,PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 UNIVERSITY DR STE 140
AUBURN HILLS MI
48326-2385
US

IV. Provider business mailing address

3121 UNIVERSITY DR STE 140
AUBURN HILLS MI
48326-2385
US

V. Phone/Fax

Practice location:
  • Phone: 248-373-7286
  • Fax: 248-475-5979
Mailing address:
  • Phone: 248-373-7286
  • Fax: 248-475-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. SAMI F RIFAT
Title or Position: DOCTOR
Credential: M.D
Phone: 248-373-7286