Provider Demographics
NPI:1699055269
Name:MOBILIZED DOCS OF MICHIGAN LLC
Entity type:Organization
Organization Name:MOBILIZED DOCS OF MICHIGAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:WARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-576-6624
Mailing Address - Street 1:725 RANDOLPH ST
Mailing Address - Street 2:APT 220
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1476
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23943 INDUSTRIAL PARK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2862
Practice Address - Country:US
Practice Address - Phone:248-615-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty