Provider Demographics
NPI:1023108438
Name:METROPOLITAN DIGESTIVE DISEASE GROUP PC
Entity type:Organization
Organization Name:METROPOLITAN DIGESTIVE DISEASE GROUP PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-HADIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-844-2600
Mailing Address - Street 1:PO BOX 71066
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5821
Mailing Address - Country:US
Mailing Address - Phone:248-844-2600
Mailing Address - Fax:248-844-0991
Practice Address - Street 1:1349 S ROCHESTER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5821
Practice Address - Country:US
Practice Address - Phone:248-844-0991
Practice Address - Fax:248-844-0991
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROPOLITAN DIGESTIVE DISEASE GROUP PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-14
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P357520Medicare ID - Type Unspecified