1033570577 NPI number — INTEGRATED & PREVENTATIVE HEALTH CARE ASSOCIATES PLC

Table of content: (NPI 1033570577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033570577 NPI number — INTEGRATED & PREVENTATIVE HEALTH CARE ASSOCIATES PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRATED & PREVENTATIVE HEALTH CARE ASSOCIATES PLC
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:
1033570577
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4057 PIONEER DR STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COMMERCE TOWNSHIP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48390-1363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-669-5050
Provider Business Mailing Address Fax Number:
248-669-1700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 HAGGERTY RD STE 2140
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST BLOOMFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48323-2191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-669-5050
Provider Business Practice Location Address Fax Number:
248-669-1700
Provider Enumeration Date:
03/11/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SYED
Authorized Official First Name:
SUZAN
Authorized Official Middle Name:
MOKHAYESH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-396-5358

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  4301081351 , 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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