Provider Demographics
NPI:1710168992
Name:MEDICAL VISITING PHYSICIANS PLLC
Entity Type:Organization
Organization Name:MEDICAL VISITING PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SALEH
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:GHAITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-333-7654
Mailing Address - Street 1:16921 W WARREN AVE
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
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:2007-11-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108289712OtherBCBS
MI110H232890OtherBC GROUP
MI025561OtherMIDWEST HEALTH PLAN
MI1033326970Medicaid
MI0P50870Medicare PIN