Provider Demographics
NPI:1679763288
Name:RAYMOND T. HAJJAR, D.O. AND CHRISTOPHER LUMLEY, D.O., P.C.
Entity Type:Organization
Organization Name:RAYMOND T. HAJJAR, D.O. AND CHRISTOPHER LUMLEY, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAJJAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:248-208-8844
Mailing Address - Street 1:31100 TELEGRAPH RD
Mailing Address - Street 2:STE 280
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4363
Mailing Address - Country:US
Mailing Address - Phone:248-208-8844
Mailing Address - Fax:248-208-1750
Practice Address - Street 1:31100 TELEGRAPH RD
Practice Address - Street 2:STE 280
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4363
Practice Address - Country:US
Practice Address - Phone:248-208-8844
Practice Address - Fax:248-208-1750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010632208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3171235-11Medicaid
MIOM13940001Medicare PIN
MI3171235-11Medicaid
MIOM13940Medicare PIN