Healthcare Provider Details

I. General information

NPI: 1699055269
Provider Name (Legal Business Name): MOBILIZED DOCS OF MICHIGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23943 INDUSTRIAL PARK DR
FARMINGTON HILLS MI
48335-2862
US

IV. Provider business mailing address

725 RANDOLPH ST APT 220
NORTHVILLE MI
48167-1476
US

V. Phone/Fax

Practice location:
  • Phone: 248-615-2225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. NADER WARAH
Title or Position: PRESIDENT
Credential:
Phone: 312-576-6624