Provider Demographics
NPI:1730361254
Name:HILLSDALE PULMONARY CRITICAL CARE AND SLEEP MEDICINE PC
Entity type:Organization
Organization Name:HILLSDALE PULMONARY CRITICAL CARE AND SLEEP MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:HASAN
Authorized Official - Last Name:ABDELKARIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-437-3879
Mailing Address - Street 1:100 E CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-1197
Mailing Address - Country:US
Mailing Address - Phone:517-849-9090
Mailing Address - Fax:517-797-4615
Practice Address - Street 1:3271 W CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-9458
Practice Address - Country:US
Practice Address - Phone:517-437-3879
Practice Address - Fax:517-437-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079293207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1225125792Medicaid
MI1225125792Medicaid
MI0P51800Medicare PIN