| Prime Care Medical Clinic Pllc | |
|
13840 W Warren Ave Dearborn MI 48126-1425 | |
| (313) 581-8080 | |
| (313) 581-8383 |
| Full Name | Prime Care Medical Clinic Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13840 W Warren Ave, Dearborn, Michigan |
| Authorized Official Name and Position | Fouad A Dakhlallah (OWNER) |
| Authorized Official Contact | 3135818080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Care Medical Clinic Pllc 13840 W Warren Ave Dearborn MI 48126-1425 Ph: (313) 581-8080 | Prime Care Medical Clinic Pllc 13840 W Warren Ave Dearborn MI 48126-1425 Ph: (313) 581-8080 |
| NPI Number | 1861702433 |
|---|---|
| Provider Enumeration Date | 10/18/2010 |
| Last Update Date | 12/01/2011 |
| Medicare PECOS PAC ID | 1052590171 |
|---|---|
| Medicare Enrollment ID | O20110121000398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861702433 | NPI | - | NPPES |
| 4753252 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301085126 (Michigan) | Primary |
| Provider Name | Fouad A Dakhlallah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679592877 PECOS PAC ID: 9830128958 Enrollment ID: I20050809000963 |
| Provider Name | Hussein Ajrouche |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073675427 PECOS PAC ID: 2163521220 Enrollment ID: I20070702000061 |
| Provider Name | Maha Alhusseini |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326333493 PECOS PAC ID: 0244531952 Enrollment ID: I20160606001163 |
| Provider Name | Talal Sabrah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124668264 PECOS PAC ID: 3072646710 Enrollment ID: I20201124000756 |
| Provider Name | Racha Bazzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679274500 PECOS PAC ID: 5597126417 Enrollment ID: I20230725002444 |
| Provider Name | Laya Nasrallah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316562432 PECOS PAC ID: 5193174910 Enrollment ID: I20231205003227 |
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