Provider Demographics
NPI:1851627053
Name:AT HOME DOCTORS, PC
Entity Type:Organization
Organization Name:AT HOME DOCTORS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVAID
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-206-1388
Mailing Address - Street 1:2843 E GRAND RIVER AVE
Mailing Address - Street 2:260
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6722
Mailing Address - Country:US
Mailing Address - Phone:517-206-1388
Mailing Address - Fax:517-708-3415
Practice Address - Street 1:1302 N EATON ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:MI
Practice Address - Zip Code:49224-1041
Practice Address - Country:US
Practice Address - Phone:517-206-1388
Practice Address - Fax:517-708-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301047107207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty