Provider Demographics
NPI:1174196281
Name:TRUST FAMILY CARE CENTER PLLC
Entity Type:Organization
Organization Name:TRUST FAMILY CARE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASMA
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:ABBAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-303-3920
Mailing Address - Street 1:2480 GOODSON ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3673
Mailing Address - Country:US
Mailing Address - Phone:313-303-3920
Mailing Address - Fax:313-338-3196
Practice Address - Street 1:9421 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3485
Practice Address - Country:US
Practice Address - Phone:313-462-4960
Practice Address - Fax:313-338-3196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty