Provider Demographics
NPI:1225071665
Name:INTENSIVE PULMONOLOGY & INTERNAL MEDICINE P C
Entity Type:Organization
Organization Name:INTENSIVE PULMONOLOGY & INTERNAL MEDICINE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:JAVAID
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-462-1233
Mailing Address - Street 1:14555 LEVAN
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5083
Mailing Address - Country:US
Mailing Address - Phone:734-462-1233
Mailing Address - Fax:734-462-3044
Practice Address - Street 1:14555 LEVAN
Practice Address - Street 2:SUITE 404
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5083
Practice Address - Country:US
Practice Address - Phone:734-462-1233
Practice Address - Fax:734-462-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI054509174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1134179880OtherMICHAEL M GAMIAO MD-MEDICARE NPI
MI3422237Medicaid
MI1124078779OtherM JAVAID YOUSUF MD-MEDICARE NPI
MI3364518Medicaid
MI1134179880OtherMICHAEL M GAMIAO MD-MEDICARE NPI
MIF29819Medicare UPIN