Provider Demographics
NPI:1487862140
Name:LAMIS,INC.
Entity Type:Organization
Organization Name:LAMIS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KANAAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-282-2020
Mailing Address - Street 1:15450 NORTHLINE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2398
Mailing Address - Country:US
Mailing Address - Phone:734-282-2020
Mailing Address - Fax:734-282-2002
Practice Address - Street 1:15450 NORTHLINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2398
Practice Address - Country:US
Practice Address - Phone:734-282-2020
Practice Address - Fax:734-282-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077121207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH35530Medicare UPIN