Provider Demographics
NPI:1033227434
Name:VISITING HOME PHYSICIANS
Entity Type:Organization
Organization Name:VISITING HOME PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-262-1439
Mailing Address - Street 1:5839 WILLOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1033
Mailing Address - Country:US
Mailing Address - Phone:734-262-1439
Mailing Address - Fax:214-975-7920
Practice Address - Street 1:5839 WILLOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1033
Practice Address - Country:US
Practice Address - Phone:734-262-1439
Practice Address - Fax:214-975-7920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033697207QG0300X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P26720Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MII37604Medicare UPIN