=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013655794
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUMMIT HEALTH POINTE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2022
-----------------------------------------------------
Last Update Date | 05/23/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21840 23 MILE RD
-----------------------------------------------------
City | MACOMB
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48042-4422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-213-1492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21840 23 MILE RD
-----------------------------------------------------
City | MACOMB
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48042-4422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-213-1492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | DR. ZAID ALJAHMI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 586-213-1492
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------