Provider Demographics
NPI:1790012250
Name:ATIF M. GEORGE, M.D., P.C.
Entity type:Organization
Organization Name:ATIF M. GEORGE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ATIF
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-543-2800
Mailing Address - Street 1:23760 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT RIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48069-1130
Mailing Address - Country:US
Mailing Address - Phone:248-543-2800
Mailing Address - Fax:
Practice Address - Street 1:23760 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:PLEASANT RIDGE
Practice Address - State:MI
Practice Address - Zip Code:48069-1130
Practice Address - Country:US
Practice Address - Phone:248-543-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAG043083207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty