Provider Demographics
NPI:1982891222
Name:PRECISE MEDICAL CARE PLLC
Entity type:Organization
Organization Name:PRECISE MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEED
Authorized Official - Middle Name:M
Authorized Official - Last Name:ATASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-752-9694
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-0037
Mailing Address - Country:US
Mailing Address - Phone:586-752-9694
Mailing Address - Fax:
Practice Address - Street 1:241 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-4619
Practice Address - Country:US
Practice Address - Phone:586-752-9694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1094667207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1982891222OtherGROUP NPI
MI1982891222Medicaid
MI110E031270OtherBLUE BLUE SHIELD GROUP PIN
MI1105004461OtherBLUE CROSS BLUE SHIELD IND PIN
MI1710969639OtherNPI
MI1982891222OtherGROUP NPI
MI=========OtherTAX ID