Maram Attiq
Individual provider Active NPI Anesthesiology Physician · Detroit, MI
NPI 1790104792 · NPPES record last updated May 8, 2020
Key facts
- NPI
- 1790104792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 4301105714 (MI)
- Practice address
- 3990 John R St # 162
Detroit, MI 48201-2018 - Phone
- (313) 745-7233
- NPI assigned
- Apr 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Beaumont Medical Group Hospital Based Services
Northstar Anesthesia of Michigan III PLLC
Practice addresses (Care Compare)
18101 Oakwood Blvd
Dearborn, MI 48124-4089
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187
44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111
Hospital & facility affiliations
- Beaumont Hospital - Dearborn
- Beaumont Hospital - Taylor
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170727001079 | MI | Practitioner - Anesthesiology | 5496056582 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Michigan III PLLC | Current |
Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Northstar Anesthesia of Michigan PLLC | Anesthesiology | Current |
Accepting new patients |
| Advantage Health/Saint Mary'S Medical Group | Current | Accepting new patients | |
| Beaumont Medical Group Hospital -Based Services | Current |
Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Oakwood Ambulatory LLC | Current |
Accepting new patients | |
| Oakwood Ambulatory, LLC | Current |
Accepting new patients | |
| Detroit Medical Center | Past | Accepting new patients |
Locations
201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065
10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850
1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500
18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780
4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615
3990 John R St
#162
Detroit, MI 48201
Phone (313) 745-7233
220 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5576
10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Interoperability endpoints
- mattiq683868@direct.trinity-health.org
- mmarouki@direct.dmc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MI | ||
| Anesthesiology Physician | 207L00000X | 4301105714 | MI | Yes |
Addresses
Primary practice location
3990 John R St # 162
Detroit, MI 48201-2018
Mailing address
6597 Whispering Woods Dr
West Bloomfield, MI 48322-5201
Other providers in Detroit, MI
- Nada Atoui
- Mustafa A Atriss
- Franco A Attanasio
- Zechariah Attar
- Attentive Hearts Home Care
- Attunigrate LLC
- Mohamed Afif Atwi
- Mary Jane Audia-Vallier
- Mark Auger
- Gabriel Augustin
All providers in Detroit, MI · Anesthesiology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.