Michigan Integrative Wellness PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009967 Issued in MI

Legal business name

MICHIGAN INTEGRATIVE WELLNESS PLLC

Practice address

15830 Fort St Ste 3
Southgate, MI 48195-1348

Phone

(734) 413-7111

NPI assigned

May 3, 2016

Organization subpart

No

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

Authorized official

Name

Abduldayem Ahmed, D.C.

Title

Provider

Phone

(734) 413-7111

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1750736203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15830 FORT ST STE 3",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951348",
            "telephone_number": "734-413-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15830 FORT ST STE 3",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951348",
            "telephone_number": "734-413-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INTEGRATIVE WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "ABDULDAYEM",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "734-413-7111",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1043560220",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Monica Mikhail, BA SOCIAL WORK
• Helen Miklos

• Chiropractor in Southgate, MI
• Providers in Southgate, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.