Provider Demographics
NPI:1790794782
Name:DIGESTIVE HEALTHCARE PLLC
Entity Type:Organization
Organization Name:DIGESTIVE HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHADIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-844-2600
Mailing Address - Street 1:2700 S ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4547
Mailing Address - Country:US
Mailing Address - Phone:248-844-2600
Mailing Address - Fax:248-844-0991
Practice Address - Street 1:2700 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4547
Practice Address - Country:US
Practice Address - Phone:248-844-2600
Practice Address - Fax:248-844-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P36770Medicare ID - Type Unspecified