Provider Demographics
NPI:1598353526
Name:MICHIGAN COMPASSIONATE CARE L.L.C.
Entity Type:Organization
Organization Name:MICHIGAN COMPASSIONATE CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:VASIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-215-9892
Mailing Address - Street 1:28401 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-5438
Mailing Address - Country:US
Mailing Address - Phone:586-754-3830
Mailing Address - Fax:586-754-3840
Practice Address - Street 1:28401 HOOVER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-5438
Practice Address - Country:US
Practice Address - Phone:586-754-3830
Practice Address - Fax:586-754-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty