Provider Demographics
NPI:1558144386
Name:IMMI HEALTH CENTER PLLC
Entity Type:Organization
Organization Name:IMMI HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PHYSICIAN IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:FADHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-906-1155
Mailing Address - Street 1:2840 GULFSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-6187
Mailing Address - Country:US
Mailing Address - Phone:989-239-9158
Mailing Address - Fax:
Practice Address - Street 1:5810 GRATIOT RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6063
Practice Address - Country:US
Practice Address - Phone:989-239-9158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty