Provider Demographics
NPI:1508106816
Name:AT HOME SLEEP CLINIC & BREATHING CENTER PLLC
Entity Type:Organization
Organization Name:AT HOME SLEEP CLINIC & BREATHING CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSSAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOUDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-401-7444
Mailing Address - Street 1:3785 BAY RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603
Mailing Address - Country:US
Mailing Address - Phone:989-791-2455
Mailing Address - Fax:989-791-1392
Practice Address - Street 1:4084 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-4019
Practice Address - Country:US
Practice Address - Phone:989-401-7444
Practice Address - Fax:989-401-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301102063261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic