Healthcare Provider Details

I. General information

NPI: 1336346030
Provider Name (Legal Business Name): MICHIGAN INFECTIOUS DISEASE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13430 13 MILE RD
WARREN MI
48088
US

IV. Provider business mailing address

13430 13 MILE RD
WARREN MI
48088
US

V. Phone/Fax

Practice location:
  • Phone: 586-427-1351
  • Fax: 586-486-5669
Mailing address:
  • Phone: 586-427-1351
  • Fax: 586-486-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAREER SUHAIL HMOUD
Title or Position: OWNER
Credential: MD
Phone: 248-635-6702