Provider Demographics
NPI:1740615632
Name:HOLISTIC HEALTH CLINIC OF GROSSE POINTE PC
Entity Type:Organization
Organization Name:HOLISTIC HEALTH CLINIC OF GROSSE POINTE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMFIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-944-2064
Mailing Address - Street 1:22790 HARPER AVE
Mailing Address - Street 2:STE C
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22790 HARPER AVE
Practice Address - Street 2:STE C
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1831
Practice Address - Country:US
Practice Address - Phone:586-944-2064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty