Provider Demographics
NPI:1568055713
Name:HBA INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:HBA INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAKIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:AQEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-682-7275
Mailing Address - Street 1:500 CASCADE WEST PKWY SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2164
Mailing Address - Country:US
Mailing Address - Phone:616-682-7275
Mailing Address - Fax:616-303-4212
Practice Address - Street 1:500 CASCADE WEST PKWY SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2164
Practice Address - Country:US
Practice Address - Phone:616-682-7275
Practice Address - Fax:616-303-4212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty