# HARTLAND GERIATRIC PC

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

## Provider details

- **NPI number:** 1396288825
- **Authorized official:** DR. FATHELRAHMNA ALI M.D. (OWNER)
- **Authorized official phone:** (313) 278-5836

## Contact information

- **Practice address:** 2040 MONROE ST, STE 207, DEARBORN, MI 48124-2950
- **Practice address phone:** (313) 278-5836
- **Mailing address:** 2040 MONROE ST, STE 207, DEARBORN, MI 48124-2950
- **Mailing address phone:** (313) 278-5836

## Taxonomy

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

## Other

- **Enumeration date:** 12/01/2016
- **Last updated:** 12/01/2016