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General NPI Number Information
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NPI Number | 1730270661
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Entity Type | Organization
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Legal Business Name | MOHAMMAD BITAR MD PC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 47389 VAN DYKE AVE
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City | SHELBY TWP
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State | MI
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Zip | 48317-3363
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Country | US
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Telephone | 586-739-8030
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Fax | 586-739-8333
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Provider Business Mailing Address
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Address Line | 47389 VAN DYKE AVE
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City | SHELBY TWP
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State | MI
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Zip | 48317-3363
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Country | US
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Telephone | 586-739-8030
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Fax | 586-739-8333
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMMAD ANAS BITAR
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Credential | MD
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Telephone | 586-739-8030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 4301059950
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License Number State | MI
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