| Michigan Primary Care Center Pc | |
|
27250 Cherry Hill Rd Dearborn Heights MI 48127-3677 | |
| (313) 406-2222 | |
| (313) 908-2687 |
| Full Name | Michigan Primary Care Center Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 27250 Cherry Hill Rd, Dearborn Heights, Michigan |
| Authorized Official Name and Position | Rodwan Fadlallah (PRESIDENT) |
| Authorized Official Contact | 3134062222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Primary Care Center Pc 27250 Cherry Hill Rd Dearborn Heights MI 48127-3677 Ph: (313) 406-2222 | Michigan Primary Care Center Pc 27250 Cherry Hill Rd Dearborn Heights MI 48127-3677 Ph: (313) 406-2222 |
| NPI Number | 1205312428 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 02/22/2023 |
| Medicare PECOS PAC ID | 9739424144 |
|---|---|
| Medicare Enrollment ID | O20181129001940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205312428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301103085 (Michigan) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Rodwan M Fadlallah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255772604 PECOS PAC ID: 5799918967 Enrollment ID: I20170308000458 |
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