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Organization
MANHAL W TOBIA M.D., P.C.
Active
Organization
MANHAL W TOBIA M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELINDA JOANNE SHAMOUN (OFFICE MANAGER)
(248) 552-1200
Entity
Organization
Contact information
Practice address
18161 W 12 MILE RD STE 2, LATHRUP VILLAGE, MI 48076-2662
(248) 552-1200
(248) 552-1201
Mailing address
18161 W 12 MILE RD STE 2, LATHRUP VILLAGE, MI 48076-2662
(248) 552-1200
(248) 552-1201
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
4301068505
MI
305R00000X
Preferred Provider Organization
MT068505
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730386913
06338982
MI
Enumeration date
06/29/2007
Last updated
10/17/2007
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