MOHAMMAD DERANI MD PC NPI 1063725620

NPI Information

NPI: 1063725620
Provider Name: MOHAMMAD DERANI MD PC

Doing Business As: DEARBORN MEDICAL CLINIC

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
15401 W WARREN AVE
DEARBORN, MI
ZIP 48126
Phone: (313) 581-0909
Get Directions

MOHAMMAD DERANI MD PC is a general practice in Dearborn, MI. MOHAMMAD DERANI MD PC NPI is 1063725620. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dearborn Medical Clinic.

The provider's business location address is:

15401 W WARREN AVE
DEARBORN, MI
ZIP 48126-359
Phone: (313) 581-0909
Fax: (313) 581-3252

The provider's authorized official is Mohammad Derani .
The authorized official title is Owner and has the following contact phone number (313) 581-0909.

The enumeration date for this NPI number is 7/23/2010 and was last updated on 2/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		4301045768	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	190127-10	MEDICAID	MICHIGAN
2	A74079	MEDICARE UPIN	MICHIGAN
3	0824892	MEDICARE PIN	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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