# MILLENNIUM MEDICAL GROUP SOUTH PC

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

## Provider details

- **NPI number:** 1265468623
- **Authorized official:** DR. ABRAHAM SLAIM D.O. (PRESIDENT)
- **Authorized official phone:** (313) 538-3099

## Contact information

- **Practice address:** 9340 TELEGRAPH RD, TAYLOR, MI 48180-3362
- **Practice address phone:** (313) 295-3388
- **Practice address fax:** (313) 295-4198
- **Mailing address:** 25241 GRAND RIVER AVE, REDFORD, MI 48240-1404
- **Mailing address phone:** (313) 538-3099
- **Mailing address fax:** (313) 538-3282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207UN0902X | Nuclear Imaging & Therapy Physician | — | NULL | — |
| 207UN0902X | Nuclear Imaging & Therapy Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/25/2006
- **Last updated:** 08/19/2008