Provider Demographics
NPI:1205126216
Name:UNITED FAMILY MEDICAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:UNITED FAMILY MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORAM
Authorized Official - Middle Name:O
Authorized Official - Last Name:MOGAKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-551-2755
Mailing Address - Street 1:PO BOX 3537
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-3537
Mailing Address - Country:US
Mailing Address - Phone:313-551-2755
Mailing Address - Fax:
Practice Address - Street 1:8044 W VERNOR HWY
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48209-1522
Practice Address - Country:US
Practice Address - Phone:313-551-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty