Provider Demographics
NPI:1265432629
Name:METRO HOSPITALISTS, PC
Entity type:Organization
Organization Name:METRO HOSPITALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAGIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-552-9673
Mailing Address - Street 1:PO BOX 250035
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-0035
Mailing Address - Country:US
Mailing Address - Phone:248-552-9673
Mailing Address - Fax:248-552-9931
Practice Address - Street 1:15565 NORTHLAND DR
Practice Address - Street 2:STE 503 WEST
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-552-9673
Practice Address - Fax:248-552-9931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIG56810Medicare UPIN
MIG65390Medicare UPIN
MII31505Medicare UPIN
MIH83831Medicare UPIN
MIH81003Medicare UPIN
MIH79530Medicare UPIN