Organization
PROSPERITY HEALTH PC
Active
Organization
PROSPERITY HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISHATH K HAKIM MD (CEO)
(248) 997-4242
Entity
Organization
Contact information
Practice address
41000 WOODWARD AVE STE 350, BLOOMFIELD HILLS, MI 48304-5092
(248) 997-4242
(248) 997-4243
Mailing address
41000 WOODWARD AVE STE 350, BLOOMFIELD HILLS, MI 48304-5092
(248) 997-4242
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083694830
INDIVIDUAL NPI
MI
01
—
4301063552
STATE LICENSE
MI
Enumeration date
07/09/2020
Last updated
07/09/2020
Update your record
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