Healthcare Provider Details

I. General information

NPI: 1447614987
Provider Name (Legal Business Name): TOTAL FAMILY HEALTH CARE PLUS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4780 OKEMOS RD SUITE 4
OKEMOS MI
48864-1669
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 517-349-3210
  • Fax:
Mailing address:
  • Phone: 517-676-9788
  • Fax: 866-427-2376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301065921
License Number StateMI

VIII. Authorized Official

Name: MAHER G AL-SHEIKH
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 517-349-3210