| International Medical Group Pllc | |
|
15301 Tireman Ave Ste A Dearborn MI 48126-1045 | |
| (313) 358-6586 | |
| Not Available |
| Full Name | International Medical Group Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15301 Tireman Ave Ste A, Dearborn, Michigan |
| Authorized Official Name and Position | Rida Barakat (OWNER) |
| Authorized Official Contact | 3133586586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| International Medical Group Pllc 15301 Tireman Ave Ste A Dearborn MI 48126-1045 Ph: (313) 358-6586 | International Medical Group Pllc 15301 Tireman Ave Ste A Dearborn MI 48126-1045 Ph: (313) 358-6586 |
| NPI Number | 1255111217 |
|---|---|
| Provider Enumeration Date | 10/05/2023 |
| Last Update Date | 10/05/2023 |
| Medicare PECOS PAC ID | 3375995046 |
|---|---|
| Medicare Enrollment ID | O20240118000355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255111217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Ali Jaber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558149658 PECOS PAC ID: 3173978749 Enrollment ID: I20231028000212 |
| Provider Name | Ali Hijazi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801674908 PECOS PAC ID: 2264887835 Enrollment ID: I20231101001690 |
| Provider Name | Rida Barakat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932761467 PECOS PAC ID: 4082074554 Enrollment ID: I20231103001112 |
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