# M DJAMALI MD PC

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

## Provider details

- **NPI number:** 1649527243
- **Authorized official:** MOHSEN DJAMALI MD (OWNER)
- **Authorized official phone:** (313) 258-8449

## Contact information

- **Practice address:** 780 N LAPEER RD, LAKE ORION, MI 48362-1529
- **Practice address phone:** (313) 258-8449
- **Practice address fax:** (734) 451-0603
- **Mailing address:** PO BOX 81936, ROCHESTER, MI 48308-1936
- **Mailing address phone:** (313) 258-8449
- **Mailing address fax:** (734) 451-0603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 4301039115 | MI | Yes |

## Other

- **Enumeration date:** 08/14/2012
- **Last updated:** 08/14/2012