| Doctors Home Line Pllc | |
|
30500 Van Dyke Ave Suite 203 Warren MI 48093-2109 | |
| (248) 480-9066 | |
| (248) 480-9062 |
| Full Name | Doctors Home Line Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 30500 Van Dyke Ave, Warren, Michigan |
| Authorized Official Name and Position | Mohmmed Yazeed Al-shihabi (PRESIDENT) |
| Authorized Official Contact | 5178126336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctors Home Line Pllc 30500 Van Dyke Ave Ste 203 Warren MI 48093-2109 Ph: (248) 480-9066 | Doctors Home Line Pllc 30500 Van Dyke Ave Suite 203 Warren MI 48093-2109 Ph: (248) 480-9066 |
| NPI Number | 1477059087 |
|---|---|
| Provider Enumeration Date | 04/03/2018 |
| Last Update Date | 04/03/2018 |
| Medicare PECOS PAC ID | 9335494582 |
|---|---|
| Medicare Enrollment ID | O20180612002872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477059087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mohmmed Yazeed Al Shihabi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679678353 PECOS PAC ID: 3678579851 Enrollment ID: I20061011000341 |
| Provider Name | Lynette Guss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639247323 PECOS PAC ID: 3577564483 Enrollment ID: I20070119000278 |
| Provider Name | Celina Comer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437400587 PECOS PAC ID: 9133379282 Enrollment ID: I20131025001358 |
| Provider Name | Ogechi Nita Enyioko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285191254 PECOS PAC ID: 9739428632 Enrollment ID: I20190311001052 |
| Provider Name | Pauline Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447713177 PECOS PAC ID: 3971845355 Enrollment ID: I20190506000745 |
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