Healthcare Provider Details

I. General information

NPI: 1346887692
Provider Name (Legal Business Name): MICHIGAN CENTER FOR HEMATOLOGY AND ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 12/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28111 HOOVER RD STE 5A
WARREN MI
48093-4153
US

IV. Provider business mailing address

20200 EDMUNTON ST
SAINT CLAIR SHORES MI
48080-1737
US

V. Phone/Fax

Practice location:
  • Phone: 412-425-4221
  • Fax:
Mailing address:
  • Phone: 412-425-4221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TARIK HIKMAT HADID
Title or Position: OWNER
Credential: MD, MPH, MS, FACP
Phone: 412-425-4221