Provider Demographics
NPI:1588672018
Name:HENEIN ARTHRITIS AND OSTEOPORSIS CENTER PC
Entity Type:Organization
Organization Name:HENEIN ARTHRITIS AND OSTEOPORSIS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIOLETTE
Authorized Official - Middle Name:FAWZY
Authorized Official - Last Name:HENEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-226-5555
Mailing Address - Street 1:39621 GARFIELD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038
Mailing Address - Country:US
Mailing Address - Phone:586-226-5555
Mailing Address - Fax:586-226-4441
Practice Address - Street 1:39621 GARFIELD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-226-5555
Practice Address - Fax:586-226-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075343207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1105016401OtherBLUE CROSS BLUE SHIELD
MIOP19020Medicare ID - Type Unspecified
MIG75731Medicare UPIN