Healthcare Provider Details

I. General information

NPI: 1063445070
Provider Name (Legal Business Name): ROCHESTER INTERNISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/02/2025
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 S ROCHESTER ROAD
ROCHESTER HILLS MI
48307
US

IV. Provider business mailing address

2708 S ROCHESTER ROAD
ROCHESTER HILLS MI
48307
US

V. Phone/Fax

Practice location:
  • Phone: 248-844-1500
  • Fax: 248-844-1501
Mailing address:
  • Phone: 248-844-1500
  • Fax: 248-844-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301060083
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301079574
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301070530
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301085362
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number4301049197
License Number StateMI
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: FADI DEMASHKIEH
Title or Position: CO-OWNER
Credential: MD
Phone: 248-844-1500