| Executive Medical Center Pllc | |
|
17000 Executive Plaza Dr Ste 104 Dearborn MI 48126-2793 | |
| (313) 879-0111 | |
| (313) 879-0222 |
| Full Name | Executive Medical Center Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17000 Executive Plaza Dr Ste 104, Dearborn, Michigan |
| Authorized Official Name and Position | Hassan Dakroub (OWNER) |
| Authorized Official Contact | 3134850111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Medical Center Pllc 17000 Executive Plaza Dr Ste 104 Dearborn MI 48126-2793 Ph: (313) 879-0111 | Executive Medical Center Pllc 17000 Executive Plaza Dr Ste 104 Dearborn MI 48126-2793 Ph: (313) 879-0111 |
| NPI Number | 1316633860 |
|---|---|
| Provider Enumeration Date | 04/17/2023 |
| Last Update Date | 10/03/2023 |
| Medicare PECOS PAC ID | 9830558758 |
|---|---|
| Medicare Enrollment ID | O20230710002188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316633860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Hassan Dakroub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528099397 PECOS PAC ID: 4981605649 Enrollment ID: I20070123000358 |
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