Organization
BELLAVISTA MEDICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMAD AL-JARRAH M.D (OWNER)
(734) 282-3236
Entity
Organization
Contact information
Practice address
15830 FORT ST, SUITE 7, SOUTHGATE, MI 48195-1367
(734) 282-3236
(734) 282-4899
Mailing address
15830 FORT ST, SUITE 7, SOUTHGATE, MI 48195-1367
(734) 282-3236
(734) 282-4899
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301057471
MI
Other
Enumeration date
02/11/2009
Last updated
06/18/2013
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