1316255169 NPI number — LOAY ASBAHI, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316255169 NPI number — LOAY ASBAHI, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOAY ASBAHI, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316255169
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
G1071 N BALLENGER HWY
Provider Second Line Business Mailing Address:
STE 206
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48504-4453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-234-1651
Provider Business Mailing Address Fax Number:
810-234-5959

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
G1071 N BALLENGER HWY
Provider Second Line Business Practice Location Address:
STE 206
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48504-4453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-234-1651
Provider Business Practice Location Address Fax Number:
810-234-5959
Provider Enumeration Date:
09/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
ALASBAHI
Authorized Official First Name:
MOHAMAD
Authorized Official Middle Name:
LOAY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
810-234-1651

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  4301083199 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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