Healthcare Provider Details

I. General information

NPI: 1750111381
Provider Name (Legal Business Name): J AMARRAH MEDICAL CARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/07/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29226 ORCHARD LAKE RD STE 170
FARMINGTON HILLS MI
48334-2984
US

IV. Provider business mailing address

29226 ORCHARD LAKE RD SSTE 170
FARMINGTON HILLS MI
48334-2984
US

V. Phone/Fax

Practice location:
  • Phone: 248-562-7716
  • Fax:
Mailing address:
  • Phone: 248-562-7716
  • Fax: 248-562-7724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. LAURENCE G SALAZAR
Title or Position: CEO/PRESIDENT
Credential:
Phone: 248-562-7716