Healthcare Provider Details

I. General information

NPI: 1508808817
Provider Name (Legal Business Name): INTEGRATED HEALTH GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24430 FORD RD SUITE B
DEARBORN HEIGHTS MI
48127-3280
US

IV. Provider business mailing address

11650 BELLEVILLE STE 105
BELLEVILLE MI
48111
US

V. Phone/Fax

Practice location:
  • Phone: 313-565-6782
  • Fax: 313-565-6784
Mailing address:
  • Phone: 734-325-6282
  • Fax: 734-865-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HUSSEIN A HURAIBI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 734-476-4845