MEDICARE: ADVANCED FAMILY CARE OF COMMERCE 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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1720253354	OTHER	MI	GROUP NPI
2	1316936008	OTHER	MI	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1720253354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FAMILY CARE OF COMMERCE PLLC

Provider Business Mailing Address
First Line	:	4123 MARTIN RD
Second Line	:	STE 102
City	:	COMMERCE TWP
State	:	MI
Zip	:	48390-4151
Country	:	US
Telephone Number	:	248-366-3700
Fax Number	:	248-360-1760

Provider Business Practice Location Address
First Line	:	4123 MARTIN RD
Second Line	:	STE 102
City	:	COMMERCE TWP
State	:	MI
Zip	:	48390-4151
Country	:	US
Telephone Number	:	248-366-3700
Fax Number	:	248-360-1760

Authorized Official
Title or Position	:	OWNER
Name	:	ADIL Y ARABBO
Credential	:	M.D.
Telephone Number	:	248-366-3700

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	07/23/2008

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