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Organization

FAMILY GASTROENTEROLOGY P L L C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IBRAHIM S SHAMIEH MD (OWNER/PHYSICIAN)
(989) 846-3500
Entity
Organization

Contact information

Practice address
805 W CEDAR ST, STANDISH, MI 48658-9526
(989) 846-3555
(989) 846-3462
Mailing address
PO BOX 125, STANDISH, MI 48658-0125
(989) 846-3500
(989) 846-3462

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301064684
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0067065
BLUE CARE NETWORK
MI
01
0988839
HEALTH PLUS OF MICHIGAN
MI
01
1629026463
INDIVIDUAL NPI
MI
01
3500670651
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
05
4255957
MI
Enumeration date
08/28/2012
Last updated
08/28/2012
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