Organization
DR. J. THWAINEY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JALAL THWAINEY MD (OWNER)
(313) 383-8310
Entity
Organization
Contact information
Practice address
7106 PARK AVE, ALLEN PARK, MI 48101-2038
(313) 383-8310
(313) 383-2756
Mailing address
7106 PARK AVE, ALLEN PARK, MI 48101-2038
(313) 383-8310
(313) 383-2756
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301047446
MI
208D00000X
General Practice Physician
4301047446
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104843672
—
MI
Enumeration date
08/16/2007
Last updated
12/18/2020
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