Provider Demographics
NPI:1033594106
Name:ATCHOO MEDICAL PRACTICE PLLC
Entity Type:Organization
Organization Name:ATCHOO MEDICAL PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ATCHOO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-506-0400
Mailing Address - Street 1:4515 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-1172
Mailing Address - Country:US
Mailing Address - Phone:248-383-8172
Mailing Address - Fax:248-599-3963
Practice Address - Street 1:4515 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-1172
Practice Address - Country:US
Practice Address - Phone:989-506-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty