Provider Demographics
NPI:1295966141
Name:GHABSHA MD PLLC
Entity type:Organization
Organization Name:GHABSHA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GHABSHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:248-651-6430
Mailing Address - Street 1:75 BARCLAY CIR STE 205
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5821
Mailing Address - Country:US
Mailing Address - Phone:248-651-6430
Mailing Address - Fax:248-650-1382
Practice Address - Street 1:75 BARCLAY CIR STE 205
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5821
Practice Address - Country:US
Practice Address - Phone:248-651-6430
Practice Address - Fax:248-650-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080822207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty