GREENFIELD MEDICAL CENTER OF DEARBORN P.C. NPI 1033389606

NPI Information

GREENFIELD MEDICAL CENTER OF DEARBORN, P.C. is a primary care clinic center in Dearborn, MI. GREENFIELD MEDICAL CENTER OF DEARBORN, P.C. NPI is 1033389606. The provider is registered as an organization entity type.

The provider's business location address is:

5479 SCHAEFER RD
DEARBORN, MI
ZIP 48126-222
Phone: (313) 581-2121
Fax: (313) 581-9206

The provider's authorized official is Mohamad Khansa .
The authorized official title is Physician Owner and has the following contact phone number (313) 581-2121.

The CLIA number assigned to this NPI record is 23D0909591 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/10/2008 and was last updated on 9/11/2008.

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:

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