Healthcare Provider Details

I. General information

NPI: 1518186758
Provider Name (Legal Business Name): HOSPITALIST SERVICE OF MICHIGAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W SQUARE LAKE RD STE 103
BLOOMFIELD HILLS MI
48302-0466
US

IV. Provider business mailing address

10 W SQUARE LAKE RD STE 103
BLOOMFIELD HILLS MI
48302-0466
US

V. Phone/Fax

Practice location:
  • Phone: 248-283-4000
  • Fax: 248-283-4444
Mailing address:
  • Phone: 248-283-4000
  • Fax: 248-283-4444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301064241
License Number StateMI

VIII. Authorized Official

Name: DR. BASHAR OKKA
Title or Position: PRESIDENT
Credential: MD
Phone: 248-625-1600