| Allen Park Medical Center Pllc | |
|
7105 Allen Rd Allen Park MI 48101-2009 | |
| (313) 509-5999 | |
| (313) 509-6500 |
| Full Name | Allen Park Medical Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7105 Allen Rd, Allen Park, Michigan |
| Authorized Official Name and Position | Mo Mazloum (BUSINESS MANAGER) |
| Authorized Official Contact | 3135095999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allen Park Medical Center Pllc 7105 Allen Rd Allen Park MI 48101-2009 Ph: (313) 509-5999 | Allen Park Medical Center Pllc 7105 Allen Rd Allen Park MI 48101-2009 Ph: (313) 509-5999 |
| NPI Number | 1992527493 |
|---|---|
| Provider Enumeration Date | 10/28/2024 |
| Last Update Date | 12/23/2024 |
| Medicare PECOS PAC ID | 5395279681 |
|---|---|
| Medicare Enrollment ID | O20241108002257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992527493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Nouh A Mazloum |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710399860 PECOS PAC ID: 1951521038 Enrollment ID: I20180609000224 |
| Provider Name | Kefah Abbas Mazloum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356093553 PECOS PAC ID: 3072988302 Enrollment ID: I20230418002490 |
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