Provider Demographics
NPI:1477059087
Name:DOCTORS HOME LINE PLLC
Entity Type:Organization
Organization Name:DOCTORS HOME LINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHMMED
Authorized Official - Middle Name:YAZEED
Authorized Official - Last Name:AL-SHIHABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-812-6336
Mailing Address - Street 1:30500 VAN DYKE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2109
Mailing Address - Country:US
Mailing Address - Phone:248-480-9066
Mailing Address - Fax:248-480-9062
Practice Address - Street 1:30500 VAN DYKE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2109
Practice Address - Country:US
Practice Address - Phone:248-480-9066
Practice Address - Fax:248-480-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty