Provider Demographics
NPI:1437572930
Name:INFINITY VISITING PHYSICIAN SERVICES PLC
Entity Type:Organization
Organization Name:INFINITY VISITING PHYSICIAN SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RADWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-854-5357
Mailing Address - Street 1:18000 W 9 MILE RD STE 630
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4009
Mailing Address - Country:US
Mailing Address - Phone:313-757-7228
Mailing Address - Fax:248-671-0175
Practice Address - Street 1:18000 W 9 MILE RD STE 630
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4009
Practice Address - Country:US
Practice Address - Phone:313-757-7228
Practice Address - Fax:248-671-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty