Provider Demographics
NPI:1710233473
Name:WEST BLOOMFIELD PROMPT CARE-PLLC
Entity Type:Organization
Organization Name:WEST BLOOMFIELD PROMPT CARE-PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:M
Authorized Official - Last Name:AL-SHAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-440-7775
Mailing Address - Street 1:6079 W MAPLE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2283
Mailing Address - Country:US
Mailing Address - Phone:248-440-7775
Mailing Address - Fax:248-440-7775
Practice Address - Street 1:6079 W MAPLE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2283
Practice Address - Country:US
Practice Address - Phone:248-440-7775
Practice Address - Fax:248-440-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty