Provider Demographics
NPI:1497040893
Name:THE DIGESTIVE DISEASE INSTITUTE, P.C.
Entity Type:Organization
Organization Name:THE DIGESTIVE DISEASE INSTITUTE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALNOUNOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-397-4717
Mailing Address - Street 1:5059 VILLA LINDE PKWY
Mailing Address - Street 2:SUITE 28
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3438
Mailing Address - Country:US
Mailing Address - Phone:810-720-7600
Mailing Address - Fax:810-720-8220
Practice Address - Street 1:5059 VILLA LINDE PKWY
Practice Address - Street 2:SUITE 28
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3438
Practice Address - Country:US
Practice Address - Phone:810-720-7600
Practice Address - Fax:810-720-8220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093129207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty