Provider Demographics
NPI:1861130114
Name:HOOVER INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:HOOVER INTERNAL MEDICINE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-656-4014
Mailing Address - Street 1:2930 HOLBROOK ST STE B
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3512
Mailing Address - Country:US
Mailing Address - Phone:313-656-4014
Mailing Address - Fax:
Practice Address - Street 1:2930 HOLBROOK ST STE B
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3512
Practice Address - Country:US
Practice Address - Phone:313-656-4014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOOVER INTERNAL MEDICINE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-26
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies