Healthcare Provider Details

I. General information

NPI: 1407586134
Provider Name (Legal Business Name): AYMAN TARABISHY MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42645 GARFIELD RD STE 103
CLINTON TOWNSHIP MI
48038-5022
US

IV. Provider business mailing address

PO BOX 30148
BELFAST ME
04915-2053
US

V. Phone/Fax

Practice location:
  • Phone: 586-286-5022
  • Fax: 586-329-4757
Mailing address:
  • Phone: 888-488-8289
  • Fax: 502-919-8790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: AYMAN TARABISHY
Title or Position: OWNER
Credential: MD
Phone: 248-516-5017