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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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