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General NPI Number Information
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NPI Number | 1780997841
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Entity Type | Organization
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Legal Business Name | TOTAL MEDICAL CARE
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 3611 CARPENTER ST STE 7
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City | DETROIT
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State | MI
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Zip | 48212-2784
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Country | US
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Telephone | 313-893-9881
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Fax | 313-893-9887
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Provider Business Mailing Address
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Address Line | 3611 CARPENTER ST STE 7
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City | DETROIT
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State | MI
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Zip | 48212-2784
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Country | US
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Telephone | 313-893-9881
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Fax | 313-893-9887
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IHSAN HAQ
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Credential | M.D.
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Telephone | 586-549-5428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | IH031344
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License Number State | MI
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