Digestive Disease Clinic PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301033455 Issued in MI

Legal business name

DIGESTIVE DISEASE CLINIC PC

Practice address

18320 Farmington Rd
Livonia, MI 48152

Phone

(248) 476-6100

Fax

(248) 471-6452

NPI assigned

Jun 11, 2012

Organization subpart

No

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

Authorized official

Name

Mowafak A Asbahi, MD

Title

Physician Owner

Phone

(248) 476-6100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1043572563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18320 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "248-476-6100",
            "fax_number": "248-476-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18320 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "248-476-6100",
            "fax_number": "248-471-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "ASBAHI",
        "authorized_official_first_name": "MOWAFAK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "248-476-6100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301033455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102699892",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.