Provider Demographics
NPI:1588850135
Name:ASSOCIATED INTERNISTS PC
Entity Type:Organization
Organization Name:ASSOCIATED INTERNISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-358-1000
Mailing Address - Street 1:26206 W 12 MILE RD
Mailing Address - Street 2:STE 300A
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1754
Mailing Address - Country:US
Mailing Address - Phone:248-358-1000
Mailing Address - Fax:248-358-1083
Practice Address - Street 1:26206 W 12 MILE RD
Practice Address - Street 2:STE 300A
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1754
Practice Address - Country:US
Practice Address - Phone:248-358-1000
Practice Address - Fax:248-358-1083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301021081207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty