Bellavista Medical Center PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301057471 Issued in MI

Legal business name

BELLAVISTA MEDICAL CENTER PLLC

Practice address

15830 Fort St
Suite 7
Southgate, MI 48195-1367

Phone

(734) 282-3236

Fax

(734) 282-4899

NPI assigned

Feb 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mohamad Al-Jarrah, M.D

Title

Owner

Phone

(734) 282-3236

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Samir Ezzat, MD

  • Family Medicine Physician
  • Dearborn, MI
  • NPI 1649285131

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1447499736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15830 FORT ST",
            "address_2": "SUITE 7",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951367",
            "telephone_number": "734-282-3236",
            "fax_number": "734-282-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15830 FORT ST",
            "address_2": "SUITE 7",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951367",
            "telephone_number": "734-282-3236",
            "fax_number": "734-282-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLAVISTA MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "AL-JARRAH",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-282-3236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301057471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belavista Drugs Inc
• Gay Lynne Bell, MSW
• Phoenix Anttiwon Bell, BA
• Tabitha Bell
• Tyrone Bell, PH.D
• Beller Chiropractic Life Center, Inc
• Bryan D. Beller, D.C.
• Christina Louise Benkert, D.O. MPH
• Alic Berdin
• David Alejando Bermudez, PHARMD

• Internal Medicine Physician in Southgate, MI
• Providers in Southgate, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.