Provider Demographics
NPI:1275731788
Name:MEDICAL PRACTICE MANAGEMENT CONSULTING PLLC
Entity Type:Organization
Organization Name:MEDICAL PRACTICE MANAGEMENT CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:AMMAR
Authorized Official - Last Name:HATAHET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-821-2150
Mailing Address - Street 1:3901 HIGHLAND RD STE A
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2162
Mailing Address - Country:US
Mailing Address - Phone:248-681-2226
Mailing Address - Fax:248-681-6494
Practice Address - Street 1:3901 HIGHLAND RD STE A
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2162
Practice Address - Country:US
Practice Address - Phone:248-681-2226
Practice Address - Fax:248-681-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F338550OtherBCBSM GROUP
MI5217692Medicaid
MI700F338550OtherBCBSM GROUP
MI5217692Medicaid
MIF45901Medicare PIN