Provider Demographics
NPI:1982015228
Name:ACCESS FAMILY GASTROENTEROLOGY PLLC
Entity Type:Organization
Organization Name:ACCESS FAMILY GASTROENTEROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TABBAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-399-6356
Mailing Address - Street 1:PO BOX 321162
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-0020
Mailing Address - Country:US
Mailing Address - Phone:810-262-2140
Mailing Address - Fax:
Practice Address - Street 1:G-1125 LINDEN RD
Practice Address - Street 2:SUITE 500
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532
Practice Address - Country:US
Practice Address - Phone:810-262-2140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty