Healthcare Provider Details

I. General information

NPI: 1609024702
Provider Name (Legal Business Name): AMERICAN ADVANCED HEALING TECHNOLOGIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8033 E 10 MILE RD SUITE 107
CENTER LINE MI
48015-1427
US

IV. Provider business mailing address

8033 E 10 MILE RD SUITE 107
CENTER LINE MI
48015-1427
US

V. Phone/Fax

Practice location:
  • Phone: 888-506-0788
  • Fax: 586-755-8054
Mailing address:
  • Phone: 888-506-0788
  • Fax: 586-755-8054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number4582026
License Number StateDE

VIII. Authorized Official

Name: RAMFIS FAHIM
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 888-506-0788