Provider Demographics
NPI:1083210488
Name:VAX SOLUTION INC
Entity Type:Organization
Organization Name:VAX SOLUTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ALATASSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-953-0526
Mailing Address - Street 1:19263 E 10 MILE RD STE D
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3903
Mailing Address - Country:US
Mailing Address - Phone:586-238-2060
Mailing Address - Fax:
Practice Address - Street 1:19263 E 10 MILE RD STE D
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-3903
Practice Address - Country:US
Practice Address - Phone:248-953-0526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty