Provider Demographics
NPI:1508808817
Name:INTEGRATED HEALTH GROUP, P.C.
Entity Type:Organization
Organization Name:INTEGRATED HEALTH GROUP, P.C.
Other - Org Name:MICHIGAN INSTITUTE OF PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HURAIBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-476-4845
Mailing Address - Street 1:11650 BELLEVILLE
Mailing Address - Street 2:STE 105
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111
Mailing Address - Country:US
Mailing Address - Phone:734-325-6282
Mailing Address - Fax:734-865-1234
Practice Address - Street 1:24430 FORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3280
Practice Address - Country:US
Practice Address - Phone:313-565-6782
Practice Address - Fax:313-565-6784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH24267OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI4708730Medicaid
OH24267OtherBLUE CROSS BLUE SHIELD OF MICHIGAN