Healthcare Provider Details
I. General information
NPI: 1588078901
Provider Name (Legal Business Name): AAIRS DIAGNOSTICS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2014
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 W. BIG BEAVER STE 107
TROY MI
48084
US
IV. Provider business mailing address
1500 W. BIG BEAVER STE 107
TROY MI
48084
US
V. Phone/Fax
- Phone: 248-689-1000
- Fax: 248-689-5711
- Phone: 248-689-1000
- Fax: 248-689-5711
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0201X |
| Taxonomy | Allergy & Immunology (Internal Medicine) Physician |
| License Number | 4301081520 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 4301081520 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
MICHEL
T.
ALKHALIL
Title or Position: OWNER
Credential: MD.
Phone: 248-689-1000