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NPI Verification

National Provider Identifier: 1760682371

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Organization

Primary Specialty

Family Medicine

Code: 207Q00000X

All Specialties (5)

Family Medicine

Code: 207Q00000X

Primary

Internal Medicine

Code: 207R00000X

Internal Medicine, Infectious Disease

Code: 207RI0200X

Pediatrics

Code: 208000000X

Pediatrics

Code: 208000000X

Practice Address

6450 MAPLE

DEARBORN, MI 48126

Phone: 313-216-2230

NPI Enumeration Date

July 21, 2007

NPI Number

1760682371

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry