Provider Demographics
NPI:1417532847
Name:MEDICAL CONSULTANT PLLC
Entity Type:Organization
Organization Name:MEDICAL CONSULTANT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-952-7445
Mailing Address - Street 1:4507 ROLLING RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:W BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-3339
Mailing Address - Country:US
Mailing Address - Phone:248-952-7445
Mailing Address - Fax:
Practice Address - Street 1:4507 ROLLING RIDGE RD
Practice Address - Street 2:
Practice Address - City:W BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-3339
Practice Address - Country:US
Practice Address - Phone:248-952-7445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty