Healthcare Provider Details

I. General information

NPI: 1962604892
Provider Name (Legal Business Name): TAREK S HAMIEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE 7TH FLOOR WEST TOWER
LANSING MI
48912
US

IV. Provider business mailing address

2800 CAMPUS DR STE 10
PLYMOUTH MN
55441-2669
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-3380
  • Fax:
Mailing address:
  • Phone: 763-398-4400
  • Fax: 651-254-1553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4301110939
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35089729
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: