Provider Demographics
NPI:1588818850
Name:THE HOSPITALIST PHYSICIANS PLLC
Entity Type:Organization
Organization Name:THE HOSPITALIST PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANAF
Authorized Official - Middle Name:
Authorized Official - Last Name:MADOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-552-0269
Mailing Address - Street 1:8679 26 MILE RD STE 326
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-2967
Mailing Address - Country:US
Mailing Address - Phone:586-552-0269
Mailing Address - Fax:586-722-0866
Practice Address - Street 1:468 CADIEUX RD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230
Practice Address - Country:US
Practice Address - Phone:586-552-0269
Practice Address - Fax:586-722-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1588818850Medicaid
MI1205834470Medicaid