Provider Demographics
NPI:1063802387
Name:EL-BOHY, TAMER A (DPT)
Entity type:Individual
Prefix:
First Name:TAMER
Middle Name:A
Last Name:EL-BOHY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3615
Mailing Address - Country:US
Mailing Address - Phone:586-698-2842
Mailing Address - Fax:586-698-2897
Practice Address - Street 1:34514 DEQUINDRE RD
Practice Address - Street 2:SUITE A3
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5232
Practice Address - Country:US
Practice Address - Phone:586-698-2842
Practice Address - Fax:586-698-2897
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016761225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist