| Onr 21 Pc | |
|
24825 Michigan Ave Ste B Dearborn MI 48124-1758 | |
| (313) 565-3365 | |
| Not Available |
| Full Name | Onr 21 Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 24825 Michigan Ave Ste B, Dearborn, Michigan |
| Authorized Official Name and Position | Omar Rahal (OWNER) |
| Authorized Official Contact | 3134423574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Onr 21 Pc 24825 Michigan Ave Ste B Dearborn MI 48124-1758 Ph: (313) 565-3365 | Onr 21 Pc 24825 Michigan Ave Ste B Dearborn MI 48124-1758 Ph: (313) 565-3365 |
| NPI Number | 1144989260 |
|---|---|
| Provider Enumeration Date | 12/16/2021 |
| Last Update Date | 12/16/2021 |
| Medicare PECOS PAC ID | 6709278948 |
|---|---|
| Medicare Enrollment ID | O20220119002322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144989260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Omar Nasser Rahal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699332734 PECOS PAC ID: 7719211143 Enrollment ID: I20220119002429 |
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