Provider Demographics
NPI:1568715894
Name:ORBIT MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:ORBIT MEDICAL GROUP PLLC
Other - Org Name:ORBIT MEDICAL GROUP PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:IBRAHIM
Authorized Official - Last Name:HOMISHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-657-8400
Mailing Address - Street 1:10990 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3058
Mailing Address - Country:US
Mailing Address - Phone:734-743-5100
Mailing Address - Fax:734-402-7164
Practice Address - Street 1:10990 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-3058
Practice Address - Country:US
Practice Address - Phone:734-743-5100
Practice Address - Fax:734-402-7164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092482261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care