Dearborn Family Clinic, P.c. | |
3133 S Telegraph Rd Dearborn MI 48124-3472 | |
(313) 565-6566 | |
(313) 561-5554 |
Full Name | Dearborn Family Clinic, P.c. |
---|---|
Speciality | Family Medicine |
Location | 3133 S Telegraph Rd, Dearborn, Michigan |
Authorized Official Name and Position | Claudia S Shannon (OFFICE MANAGER) |
Authorized Official Contact | 3135656566 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dearborn Family Clinic, P.c. 3133 S Telegraph Rd Dearborn MI 48124-3472 Ph: (313) 565-6566 | Dearborn Family Clinic, P.c. 3133 S Telegraph Rd Dearborn MI 48124-3472 Ph: (313) 565-6566 |
NPI Number | 1013928035 |
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Provider Enumeration Date | 08/11/2006 |
Last Update Date | 10/16/2022 |
Medicare PECOS PAC ID | 3072591056 |
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Medicare Enrollment ID | O20040708000233 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013928035 | NPI | - | NPPES |
4622742 | Medicaid | MI | |
1387925 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | HW007561 (Michigan) | Primary |
Provider Name | Howard Mark Wright |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952390957 PECOS PAC ID: 2062492770 Enrollment ID: I20101008000056 |
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