Provider Demographics
NPI:1629564810
Name:FEELING GOOD MEDICAL CENTER PLLC
Entity Type:Organization
Organization Name:FEELING GOOD MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOSHRA
Authorized Official - Middle Name:ABDULRAHMAN
Authorized Official - Last Name:ALMOAYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-483-9337
Mailing Address - Street 1:3 PEMBROKE CT
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4203
Mailing Address - Country:US
Mailing Address - Phone:313-483-9337
Mailing Address - Fax:313-483-9356
Practice Address - Street 1:1952 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2917
Practice Address - Country:US
Practice Address - Phone:313-483-9337
Practice Address - Fax:313-483-9356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA579542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1447323829Medicaid