| Numina Health Group, Pllc | |
|
835 Mason St Ste A220 Dearborn MI 48124-2246 | |
| (313) 515-1077 | |
| Not Available |
| Full Name | Numina Health Group, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 835 Mason St Ste A220, Dearborn, Michigan |
| Authorized Official Name and Position | Shadi Restum (OWNER) |
| Authorized Official Contact | 3135151077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Numina Health Group, Pllc 835 Mason St Ste A220 Dearborn MI 48124-2246 Ph: (313) 515-1077 | Numina Health Group, Pllc 835 Mason St Ste A220 Dearborn MI 48124-2246 Ph: (313) 515-1077 |
| NPI Number | 1134986599 |
|---|---|
| Provider Enumeration Date | 03/04/2024 |
| Last Update Date | 03/21/2024 |
| Certification Date | 03/21/2024 |
| Medicare PECOS PAC ID | 4880033224 |
|---|---|
| Medicare Enrollment ID | O20240417002670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134986599 | NPI | - | NPPES |
| Provider Name | Theyazan Kohaif |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881053874 PECOS PAC ID: 5092186452 Enrollment ID: I20230121000072 |
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