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General NPI Number Information
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NPI Number | 1962449116
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Entity Type | Organization
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Legal Business Name | WEST MI. REGIONAL CANCER AND BLOOD CENTER
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 6050 N US HIGHWAY 31
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City | FREE SOIL
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State | MI
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Zip | 49411-9157
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Country | US
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Telephone | 231-757-1260
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Fax | 231-757-1261
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Provider Business Mailing Address
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Address Line | 6050 N US HIGHWAY 31
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City | FREE SOIL
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State | MI
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Zip | 49411-9157
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Country | US
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Telephone | 231-757-1260
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Fax | 231-757-1261
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Authorized Official
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Title or Position | OWNER
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Name | MR. AHMED SOLIMAN BEHAIRY
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Credential | M.D.
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Telephone | 231-757-1260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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