Provider Demographics
NPI:1619208808
Name:HOME PHYSICIANS
Entity type:Organization
Organization Name:HOME PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-404-5980
Mailing Address - Street 1:5860 N CANTON CENTER RD
Mailing Address - Street 2:STE 340
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2687
Mailing Address - Country:US
Mailing Address - Phone:734-404-5980
Mailing Address - Fax:734-404-5981
Practice Address - Street 1:5860 N CANTON CENTER RD
Practice Address - Street 2:STE 340
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2687
Practice Address - Country:US
Practice Address - Phone:734-404-5980
Practice Address - Fax:734-404-5981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI2785Medicare UPIN