Provider Demographics
NPI:1396345666
Name:ANHA MEDICAL PC
Entity type:Organization
Organization Name:ANHA MEDICAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:MOUSTAFA
Authorized Official - Last Name:EL-FAKHARANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-207-6210
Mailing Address - Street 1:6402 GOLFVIEW ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2005
Mailing Address - Country:US
Mailing Address - Phone:313-207-6210
Mailing Address - Fax:
Practice Address - Street 1:704 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-1841
Practice Address - Country:US
Practice Address - Phone:313-207-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center