# LIVEWELL MEDICAL GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043096688
- **Authorized official:** DIANA EL MASRI (BILLING MANAGER)
- **Authorized official phone:** (248) 215-0048

## Contact information

- **Practice address:** 3611 CARPENTER ST STE 5, HAMTRAMCK, MI 48212-2784
- **Practice address phone:** (313) 733-8286
- **Practice address fax:** (313) 826-0899
- **Mailing address:** 3611 CARPENTER ST STE 5, HAMTRAMCK, MI 48212-2784
- **Mailing address phone:** (313) 733-8286
- **Mailing address fax:** (313) 826-0899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/07/2023
- **Last updated:** 09/26/2023