Provider Demographics
NPI:1619241718
Name:INFINITY PRIMARY MEDICINE GROUP
Entity Type:Organization
Organization Name:INFINITY PRIMARY MEDICINE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-914-5270
Mailing Address - Street 1:16921 W WARREN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3504
Mailing Address - Country:US
Mailing Address - Phone:313-914-5270
Mailing Address - Fax:313-757-7144
Practice Address - Street 1:16921 W WARREN AVE STE B
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3504
Practice Address - Country:US
Practice Address - Phone:313-914-5270
Practice Address - Fax:313-757-7144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084363207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty