Warren Gastroenterology PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

WARREN GASTROENTEROLOGY PC

Practice address

27560 Hoover Rd
Warren, MI 48093-4505

Phone

(586) 757-6400

Fax

(586) 757-8400

NPI assigned

Jun 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ghaith M Ibrahim, MD

Title

President

Phone

(586) 757-6400

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hayan Jaratli, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1285898908
  Medicare reassignment Care Compare group NPD
• Rabei W Bdeir, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Pontiac, MI
  • NPI 1619920634
  Medicare reassignment Care Compare group
• Rafic Beydoun, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1831455138
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1023211422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1920",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991920",
            "telephone_number": "586-757-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27560 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934505",
            "telephone_number": "586-757-6400",
            "fax_number": "586-757-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN GASTROENTEROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "GHAITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-757-6400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4813806",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Warren Dental Reflections, PLC
• Warren Family Dentistry
• Warren Family Medical Center PLLC
• Warren Family Pharmacy LLC
• Warren Family Practice, PLLC
• Warren Geriatric Village, Inc
• Warren Group Dental Associates PLLC
• Warren Laser Dentistry
• Warren Medical Pharmacy LLC
• Warren Mi Opco LLC

• Gastroenterology Physician in Warren, MI
• Providers in Warren, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.