Provider Demographics
NPI:1174792600
Name:MOHAMMAD BATAYNEH M.D. P.C.
Entity type:Organization
Organization Name:MOHAMMAD BATAYNEH M.D. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:KHALAF
Authorized Official - Last Name:BATAYNEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-425-7150
Mailing Address - Street 1:32472 SCHOOLCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-4309
Mailing Address - Country:US
Mailing Address - Phone:734-425-7150
Mailing Address - Fax:734-425-7151
Practice Address - Street 1:32472 SCHOOLCRAFT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-4309
Practice Address - Country:US
Practice Address - Phone:734-425-7150
Practice Address - Fax:734-425-7151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOHAMMAD BATAYNEH M.D. P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4103033756207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2095282Medicaid
MI0825111Medicaid
MI2095282Medicaid
MI0825111Medicaid
MI0825111Medicare PIN