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NPI Code Detail

MEDICARE: CAPITAL HEALTHCARE LLC

MEDICARE: CAPITAL HEALTHCARE LLC
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
1207T00000XNeurological Surgery Physician4301102325MI
2208VP0000XPain Medicine Physician4301102325MI
3261QA1903XAmbulatory Surgical Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518211440
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAPITAL HEALTHCARE LLC
Provider Business Mailing Address
First Line : 2700 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-4547
Country : US
Telephone Number : 248-212-0777
Fax Number : 248-575-4144
Provider Business Practice Location Address
First Line : 2700 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-4547
Country : US
Telephone Number : 248-212-0777
Fax Number : 248-575-4144
Authorized Official
Title or Position : CEO
Name : DR. USAMA GABR
Credential : MD
Telephone Number : 248-212-0777
Provider Enumeration Date : 10/30/2012
Last Update Date : 06/25/2019

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Directions to “CAPITAL HEALTHCARE LLC ” Practice Location

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