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General NPI Number Information
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NPI Number | 1134926454
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Entity Type | Organization
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Legal Business Name | MID-MICHIGAN SPECIALTY CLINICS PLLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 8203 S SAGINAW ST STE B
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City | GRAND BLANC
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State | MI
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Zip | 48439-2434
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Country | US
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Telephone | 810-410-4869
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Fax |
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Provider Business Mailing Address
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Address Line | 8203 S SAGINAW ST STE B
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City | GRAND BLANC
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State | MI
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Zip | 48439-2434
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Country | US
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Telephone | 810-410-4869
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. FAISAL MAWRI
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Credential | MD
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Telephone | 810-410-4869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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