Provider Demographics
NPI:1053445973
Name:CHBIHI, TAIBI (PA-C)
Entity Type:Individual
Prefix:
First Name:TAIBI
Middle Name:
Last Name:CHBIHI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-6709
Mailing Address - Country:US
Mailing Address - Phone:734-240-9952
Mailing Address - Fax:248-964-3810
Practice Address - Street 1:44199 DEQUINDRE
Practice Address - Street 2:SUITE 400
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085
Practice Address - Country:US
Practice Address - Phone:240-964-3805
Practice Address - Fax:240-964-3810
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003382363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N370000024Medicare PIN