Provider Demographics
NPI:1063445070
Name:ROCHESTER INTERNISTS, PLLC
Entity Type:Organization
Organization Name:ROCHESTER INTERNISTS, PLLC
Other - Org Name:WASHINGTON URGENT CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMASHKIEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-844-1500
Mailing Address - Street 1:2708 S ROCHESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-844-1500
Mailing Address - Fax:248-844-1501
Practice Address - Street 1:2708 S ROCHESTER ROAD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-844-1500
Practice Address - Fax:248-844-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060083207R00000X
MI4301085362207R00000X
MI4301079574207R00000X
207R00000X
MI4301070530207RC0000X
MI4301049197207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F328090OtherBCBSM
0P28480Medicare PIN