Healthcare Provider Details

I. General information

NPI: 1811658578
Provider Name (Legal Business Name): SERENITY DOCTORS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 E LONG LAKE RD
BLOOMFIELD HILLS MI
48304-9996
US

IV. Provider business mailing address

16000 SOUTHFIELD RD
ALLEN PARK MI
48101-2563
US

V. Phone/Fax

Practice location:
  • Phone: 248-533-0000
  • Fax:
Mailing address:
  • Phone: 313-928-4444
  • Fax: 313-928-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ALI ALHIMIRI
Title or Position: OWNER
Credential: MD
Phone: 248-533-0000