1972805885 NPI number — HAWASLI & ASSOCIATES TRAUMA & ACUTE CARE SURGEONS, P.C.

Table of content: (NPI 1972805885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972805885 NPI number — HAWASLI & ASSOCIATES TRAUMA & ACUTE CARE SURGEONS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAWASLI & ASSOCIATES TRAUMA & ACUTE CARE SURGEONS, P.C.
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:
1972805885
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 77000
Provider Second Line Business Mailing Address:
DEPT 771481
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48277-1481
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-844-3155
Provider Business Mailing Address Fax Number:
734-844-3156

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24911 LITTLE MACK
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
ST CLAIRE SHORES
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-844-3155
Provider Business Practice Location Address Fax Number:
734-844-3156
Provider Enumeration Date:
11/29/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HAWASLI
Authorized Official First Name:
ABDELKADER
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
734-844-3155

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  4301044113 , 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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