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General NPI Number Information
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NPI Number | 1275104333
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Entity Type | Organization
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Legal Business Name | CANTON FAMILY HEALTH LLC
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 6300 N HAGGERTY RD STE 220
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City | CANTON
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State | MI
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Zip | 48187-4472
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Country | US
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Telephone | 313-283-1019
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Fax |
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Provider Business Mailing Address
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Address Line | 6698 KINGS MILL DR
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City | CANTON
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State | MI
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Zip | 48187-5473
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Country | US
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Telephone | 313-283-1019
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMIH AJAMI
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Credential | DO
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Telephone | 313-283-1019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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