Provider Demographics
NPI:1780734095
Name:A ACCESS PC
Entity type:Organization
Organization Name:A ACCESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-479-2380
Mailing Address - Street 1:15530 KING RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7943
Mailing Address - Country:US
Mailing Address - Phone:734-479-2380
Mailing Address - Fax:734-479-2382
Practice Address - Street 1:1640 FORT ST
Practice Address - Street 2:SUITE E
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2040
Practice Address - Country:US
Practice Address - Phone:734-675-9888
Practice Address - Fax:734-675-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301021897207Q00000X
MI4301087179207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM43140Medicare PIN