MEDICARE: SOLIS MEDICAL GROUP PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TA0700X	Adult Development & Aging Psychologist
2	163WW0000X	Wound Care Registered Nurse
3	207N00000X	Dermatology Physician
4	207NS0135X	Procedural Dermatology Physician
5	207QG0300X	Geriatric Medicine (Family Medicine) Physician
6	207RG0300X	Geriatric Medicine (Internal Medicine) Physician
7	363LP2300X	Primary Care Nurse Practitioner
8	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1831984269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLIS MEDICAL GROUP PC

Provider Business Mailing Address
First Line	:	6659 SCHAEFER RD STE 155
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-1812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	341 EVIAN WAY
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-9261
Country	:	US
Telephone Number	:	313-392-3234
Fax Number	:

Authorized Official
Title or Position	:	MSO
Name	:	ALI ZREIK
Credential	:
Telephone Number	:	313-392-3234

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	05/21/2025

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