Provider Demographics
NPI:1952503559
Name:SOLIMAN MEDICAL CENTER PLLC
Entity Type:Organization
Organization Name:SOLIMAN MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKHAYL
Authorized Official - Middle Name:SAMY
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-326-5903
Mailing Address - Street 1:3152 S WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1221
Mailing Address - Country:US
Mailing Address - Phone:734-326-5903
Mailing Address - Fax:734-326-5904
Practice Address - Street 1:3152 S WAYNE RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1221
Practice Address - Country:US
Practice Address - Phone:734-326-5903
Practice Address - Fax:734-326-5904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4845900Medicaid
MI0P30360Medicare ID - Type UnspecifiedMEIDARE GROUP NUMBER
MI4845900Medicaid
MIP30360001Medicare PIN