MEDICARE: INTEGRATED & PREVENTATIVE HEALTH CARE ASSOCIATES PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301081351	MI

General Provider Information

NPI Number	:	1033570577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED & PREVENTATIVE HEALTH CARE ASSOCIATES PLC

Provider Business Mailing Address
First Line	:	4057 PIONEER DR STE 300
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48390-1363
Country	:	US
Telephone Number	:	248-669-5050
Fax Number	:	248-669-1700

Provider Business Practice Location Address
First Line	:	2300 HAGGERTY RD STE 2140
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2191
Country	:	US
Telephone Number	:	248-669-5050
Fax Number	:	248-669-1700

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SUZAN MOKHAYESH SYED
Credential	:	M.D.
Telephone Number	:	248-396-5358

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	11/02/2023

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