MEDICARE: MICHIGAN SLEEP INSTITUTE 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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	079293	MI

General Provider Information

NPI Number	:	1609107432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN SLEEP INSTITUTE PLLC

Provider Business Mailing Address
First Line	:	100 E CHICAGO ST
Second Line	:
City	:	JONESVILLE
State	:	MI
Zip	:	49250-1197
Country	:	US
Telephone Number	:	517-849-9090
Fax Number	:	517-797-4615

Provider Business Practice Location Address
First Line	:	605 W CHICAGO RD STE 208
Second Line	:
City	:	COLDWATER
State	:	MI
Zip	:	49036-8400
Country	:	US
Telephone Number	:	517-924-1444
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TARIQ ABDELKARIM
Credential	:	MD
Telephone Number	:	517-924-1444

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	05/11/2021

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