Provider Demographics
NPI:1194504423
Name:CEDAR MEDICAL SNF SERVICES PLLC
Entity type:Organization
Organization Name:CEDAR MEDICAL SNF SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:GHORAYEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-563-5757
Mailing Address - Street 1:1951 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2916
Mailing Address - Country:US
Mailing Address - Phone:313-563-5757
Mailing Address - Fax:
Practice Address - Street 1:1951 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2916
Practice Address - Country:US
Practice Address - Phone:313-563-5757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty