Healthcare Provider Details

I. General information

NPI: 1760827984
Provider Name (Legal Business Name): RMR WEIGHT MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4058 W WILSON RD
CLIO MI
48420-9481
US

IV. Provider business mailing address

10242 SHARP RD
SWARTZ CREEK MI
48473-9156
US

V. Phone/Fax

Practice location:
  • Phone: 810-444-2749
  • Fax:
Mailing address:
  • Phone: 810-444-2749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code132700000X
TaxonomyDietary Manager
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MR. WAEL AWAD SAMARAH
Title or Position: OWNER/OPERATOR
Credential: BS, ALCS,BS
Phone: 810-444-2749