Provider Demographics
NPI:1679787170
Name:ABDEL-WAHAB MERI MD PC
Entity Type:Organization
Organization Name:ABDEL-WAHAB MERI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELREATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-963-0555
Mailing Address - Street 1:75 BARCLAY CIR STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5803
Mailing Address - Country:US
Mailing Address - Phone:248-963-0555
Mailing Address - Fax:248-841-4840
Practice Address - Street 1:75 BARCLAY CIR STE 120
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5803
Practice Address - Country:US
Practice Address - Phone:248-963-0555
Practice Address - Fax:248-841-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM076045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P00430Medicare PIN