Healthcare Provider Details

I. General information

NPI: 1144562083
Provider Name (Legal Business Name): INTEGRATED HEALTH GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 03/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 GREENFIELD RD
DEARBORN MI
48126-4124
US

IV. Provider business mailing address

19785 W 12 MILE RD SUITE 679
SOUTHFIELD MI
48076-2584
US

V. Phone/Fax

Practice location:
  • Phone: 313-624-9470
  • Fax: 313-624-9471
Mailing address:
  • Phone: 248-514-2342
  • Fax: 248-443-0165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: HUSSEIN HURAIBI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 313-565-6782