| Primary Care Center Pllc | |
|
3902 Monroe St Dearborn Heights MI 48125-2545 | |
| (313) 562-1985 | |
| (313) 562-0380 |
| Full Name | Primary Care Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3902 Monroe St, Dearborn Heights, Michigan |
| Authorized Official Name and Position | Naiff Ali (SOLE MBR) |
| Authorized Official Contact | 3139320185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Center Pllc 3902 Monroe St Dearborn Heights MI 48125-2545 Ph: (313) 562-1985 | Primary Care Center Pllc 3902 Monroe St Dearborn Heights MI 48125-2545 Ph: (313) 562-1985 |
| NPI Number | 1780292623 |
|---|---|
| Provider Enumeration Date | 07/16/2020 |
| Last Update Date | 08/09/2022 |
| Medicare PECOS PAC ID | 1254751175 |
|---|---|
| Medicare Enrollment ID | O20201015000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780292623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David L Cooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528025871 PECOS PAC ID: 6305944620 Enrollment ID: I20070611000573 |
| Provider Name | Martha E Genig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902009822 PECOS PAC ID: 0648431189 Enrollment ID: I20120411000036 |
| Provider Name | Naiff Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992151401 PECOS PAC ID: 4284924101 Enrollment ID: I20200720000093 |
| Provider Name | Danielle Dicicco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245705490 PECOS PAC ID: 7416365895 Enrollment ID: I20210423001745 |
| Provider Name | Eman Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467065458 PECOS PAC ID: 5890133573 Enrollment ID: I20240401000241 |
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