MEDICARE: ATCHOO MEDICAL PRACTICE PLLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1033594106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATCHOO MEDICAL PRACTICE PLLC

Provider Business Mailing Address
First Line	:	4511 HIGHLAND RD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48328-1132
Country	:	US
Telephone Number	:	248-383-8172
Fax Number	:	248-599-3963

Provider Business Practice Location Address
First Line	:	4511 HIGHLAND RD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48328-1132
Country	:	US
Telephone Number	:	248-383-8172
Fax Number	:	248-599-3963

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FARIS ATCHOO
Credential	:	D.O.
Telephone Number	:	989-506-0400

Provider Enumeration Date	:	07/29/2015
Last Update Date	:	06/26/2026

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