Provider Demographics
NPI:1770111379
Name:JANAN HAWIL, MD, PC
Entity type:Organization
Organization Name:JANAN HAWIL, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-795-2980
Mailing Address - Street 1:35450 DEQUINDRE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4810
Mailing Address - Country:US
Mailing Address - Phone:586-795-2980
Mailing Address - Fax:586-795-3419
Practice Address - Street 1:35450 DEQUINDRE RD STE 103
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4810
Practice Address - Country:US
Practice Address - Phone:586-795-2980
Practice Address - Fax:586-795-3419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1609082247Medicaid