Provider Demographics
NPI:1679670889
Name:DOCTORS AT HOME P.LC.
Entity Type:Organization
Organization Name:DOCTORS AT HOME P.LC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABBAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSTOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-377-8829
Mailing Address - Street 1:20755 GREENFIELD RD
Mailing Address - Street 2:SUIT 601
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5403
Mailing Address - Country:US
Mailing Address - Phone:248-424-4545
Mailing Address - Fax:248-424-4847
Practice Address - Street 1:20755 GREENFIELD RD
Practice Address - Street 2:SUIT 601
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5403
Practice Address - Country:US
Practice Address - Phone:248-424-4545
Practice Address - Fax:248-424-4847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty