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22350 Ford Rd Dearborn Heights MI 48127-2421 | |
| (313) 406-2410 | |
| (313) 406-6484 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 22350 Ford Rd, Dearborn Heights, Michigan |
| Authorized Official Name and Position | Sally Khalifa (PHYSICIAN) |
| Authorized Official Contact | 3134062410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
22350 Ford Rd Dearborn Heights MI 48127-2421 Ph: (313) 406-2410 | 22350 Ford Rd Dearborn Heights MI 48127-2421 Ph: (313) 406-2410 |
| NPI Number | 1285198291 |
|---|---|
| Provider Enumeration Date | 01/23/2019 |
| Last Update Date | 01/24/2019 |
| Medicare PECOS PAC ID | 9234478850 |
|---|---|
| Medicare Enrollment ID | O20190226002717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285198291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Hussein Christopher Khraizat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932588381 PECOS PAC ID: 9436448313 Enrollment ID: I20180801002370 |
| Provider Name | Sally M Khalifa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427430487 PECOS PAC ID: 0244540490 Enrollment ID: I20190226003001 |
| Provider Name | Lilian Elhur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346084621 PECOS PAC ID: 1153853510 Enrollment ID: I20241105003459 |
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