Provider Demographics
NPI:1487816419
Name:ADVANCED PULMONARY & SLEEP ASSOCIATES PC
Entity Type:Organization
Organization Name:ADVANCED PULMONARY & SLEEP ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEEBAJAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-333-6733
Mailing Address - Street 1:1110 N TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1203
Mailing Address - Country:US
Mailing Address - Phone:313-294-5400
Mailing Address - Fax:313-294-5401
Practice Address - Street 1:1110 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1634
Practice Address - Country:US
Practice Address - Phone:313-294-5400
Practice Address - Fax:313-294-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067420207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI290H242810OtherBCBS GROUP
MI82027712OtherPROCARE
MI1109501061OtherBCN
MIDN8728OtherRAILROAD MEDICARE GROUP
MI026029OtherMIDWEST HEALTH PLAN
MI1109500421OtherBC
MI1109500421OtherBCN
MI1109501061OtherBCBS
MI290H242810OtherBCN GROUP
MI1109501061OtherBCN
MI290H242810OtherBCBS GROUP