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Organization

FORUM MEDICAL CLINIC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NICOLAS A MARSHEH IV M.D. (OWNER/OPERATOR)
(586) 580-0280
Entity
Organization

Contact information

Practice address
43184 DEQUINDRE RD STE 202, STERLING HEIGHTS, MI 48314-1709
(586) 580-0280
(586) 580-0281
Mailing address
43184 DEQUINDRE RD STE 202, STERLING HEIGHTS, MI 48314-1709
(586) 580-0280
(586) 580-0281

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
NM 069838
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E00984
BCBS
MI
01
1106348002
BCBSM
MI
05
4732824
MI
Enumeration date
07/03/2006
Last updated
03/07/2023
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