Healthcare Provider Details
I. General information
NPI: 1033901723
Provider Name (Legal Business Name): MICHIGAN HEALTH PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27750 MIDDLEBELT RD STE 100
FARMINGTON HILLS MI
48334-5006
US
IV. Provider business mailing address
27750 MIDDLEBELT RD STE 100
FARMINGTON HILLS MI
48334-5006
US
V. Phone/Fax
- Phone: 248-702-5050
- Fax: 877-408-1039
- Phone: 248-702-5050
- Fax: 877-408-1039
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
MAAROUF
Title or Position: OWNER
Credential: DO
Phone: 586-994-1816