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General NPI Number Information
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NPI Number | 1568715894
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Entity Type | Organization
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Legal Business Name | ORBIT MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 10/24/2012
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 10990 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48150-3058
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Country | US
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Telephone | 734-743-5100
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Fax | 734-402-7164
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Provider Business Mailing Address
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Address Line | 10990 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48150-3058
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Country | US
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Telephone | 734-743-5100
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Fax | 734-402-7164
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Authorized Official
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Title or Position | MEDICAL DIRECTOR AND OWNER
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Name | DR. SAMER IBRAHIM HOMISHA
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Credential | M.D
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Telephone | 313-657-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 4301092482
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License Number State | MI
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