| Pelham Primary Care Pc | |
|
3815 Pelham St Dearborn MI 48124-3852 | |
| (313) 789-7636 | |
| (313) 789-7018 |
| Full Name | Pelham Primary Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3815 Pelham St, Dearborn, Michigan |
| Authorized Official Name and Position | Ribhi Hazin (PARTNER) |
| Authorized Official Contact | 3137897636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pelham Primary Care Pc 3815 Pelham St Dearborn MI 48124-3852 Ph: (313) 789-7636 | Pelham Primary Care Pc 3815 Pelham St Dearborn MI 48124-3852 Ph: (313) 789-7636 |
| NPI Number | 1336665728 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 0446524649 |
|---|---|
| Medicare Enrollment ID | O20170927002443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336665728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Talal T M Khader |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033314513 PECOS PAC ID: 2668665068 Enrollment ID: I20101018001177 |
| Provider Name | Ribhi Hazin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265747463 PECOS PAC ID: 6901038140 Enrollment ID: I20140422001446 |
| Provider Name | Amy Amira Yousif |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487178174 PECOS PAC ID: 3870859150 Enrollment ID: I20171102003112 |
| Provider Name | Tarick Nael Elayan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922747054 PECOS PAC ID: 0547644833 Enrollment ID: I20220906002259 |
| Provider Name | Amanda Kassab |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760188312 PECOS PAC ID: 4183071046 Enrollment ID: I20231114002958 |
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