Provider Demographics
NPI:1033570577
Name:INTEGRATED & PREVENTATIVE HEALTH CARE ASSOCIATES PLC
Entity Type:Organization
Organization Name:INTEGRATED & PREVENTATIVE HEALTH CARE ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZAN
Authorized Official - Middle Name:MOKHAYESH
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-396-5358
Mailing Address - Street 1:4057 PIONEER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-1363
Mailing Address - Country:US
Mailing Address - Phone:248-669-5050
Mailing Address - Fax:248-669-1700
Practice Address - Street 1:2300 HAGGERTY RD STE 2140
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2191
Practice Address - Country:US
Practice Address - Phone:248-669-5050
Practice Address - Fax:248-669-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN89750001Medicare PIN