| East Dearborn Medical Clinic Pc | |
|
14650 W Warren Ave Ste 150 Dearborn MI 48126-1799 | |
| (313) 581-0200 | |
| (313) 582-3300 |
| Full Name | East Dearborn Medical Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14650 W Warren Ave, Dearborn, Michigan |
| Authorized Official Name and Position | Abdul Mhanna (OWNER) |
| Authorized Official Contact | 3135810200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Dearborn Medical Clinic Pc 14650 W Warren Ave Ste 150 Dearborn MI 48126-1799 Ph: (313) 581-0200 | East Dearborn Medical Clinic Pc 14650 W Warren Ave Ste 150 Dearborn MI 48126-1799 Ph: (313) 581-0200 |
| NPI Number | 1871043000 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 11/01/2016 |
| Medicare PECOS PAC ID | 8325327141 |
|---|---|
| Medicare Enrollment ID | O20161118002060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871043000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4301069195 (Michigan) | Primary |
| Provider Name | Adham Ahmad Sayed-ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689789992 PECOS PAC ID: 9739147752 Enrollment ID: I20041222000341 |
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