Organization
A3 PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA EL MASRI (CREDENTIALING COORDINATOR)
(248) 215-0048
Entity
Organization
Contact information
Practice address
4050 W MAPLE RD STE B, BLOOMFIELD HILLS, MI 48301-3148
(248) 885-8211
Mailing address
4050 W MAPLE RD STE B, BLOOMFIELD HILLS, MI 48301-3148
(248) 885-8211
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
06/18/2024
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