Provider Demographics
NPI:1790340958
Name:MERCY HOSPITALISTS, PLLC
Entity Type:Organization
Organization Name:MERCY HOSPITALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALLOUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-930-8903
Mailing Address - Street 1:10 W SQUARE LAKE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0466
Mailing Address - Country:US
Mailing Address - Phone:248-283-4000
Mailing Address - Fax:248-283-4444
Practice Address - Street 1:10 W SQUARE LAKE RD STE 103
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0466
Practice Address - Country:US
Practice Address - Phone:248-283-4000
Practice Address - Fax:248-283-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty