Healthcare Provider Details

I. General information

NPI: 1003244625
Provider Name (Legal Business Name): COMMUNITY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37935 W 12 MILE RD STE A
FARMINGTON HILLS MI
48331-6102
US

IV. Provider business mailing address

PO BOX 87401
CANTON MI
48187-0401
US

V. Phone/Fax

Practice location:
  • Phone: 248-579-9009
  • Fax: 248-579-9009
Mailing address:
  • Phone: 248-579-9009
  • Fax: 248-579-9009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. MUSTAFA HASHEM
Title or Position: CEO/ MEDICAL DIRECTOR
Credential: M.D.
Phone: 248-579-9009