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General NPI Number Information
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NPI Number | 1417248139
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Entity Type | Organization
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Legal Business Name | ADVANCE CARING PHYSICIANS LLP
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 7612 GRATIOT AVE
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City | DETROIT
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State | MI
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Zip | 48213-2822
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Country | US
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Telephone | 313-397-1907
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Fax | 313-397-2125
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Provider Business Mailing Address
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Address Line | PO BOX 871400
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City | CANTON
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State | MI
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Zip | 48187-7300
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Country | US
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Telephone | 313-397-1907
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Fax | 313-397-2125
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Authorized Official
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Title or Position | OWNER
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Name | KAMAL IBRAHIM
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Credential | MD
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Telephone | 313-397-1907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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