Provider Demographics
NPI:1922478601
Name:SLIM INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:SLIM INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ACHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:SLIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-461-1190
Mailing Address - Street 1:5260 SCHAEFER RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3228
Mailing Address - Country:US
Mailing Address - Phone:313-461-1190
Mailing Address - Fax:
Practice Address - Street 1:5260 SCHAEFER RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3228
Practice Address - Country:US
Practice Address - Phone:313-461-1190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP28070576Medicare PIN
MIMI2907362Medicare PIN