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MICHIGAN SPECIALTY CLINIC PLLC NPI 1760700660


NPI Information

NPI: 1760700660
Provider Name: MICHIGAN SPECIALTY CLINIC PLLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
13530 MICHIGAN AVE
SUITE 120
DEARBORN, MI
ZIP 48126
Phone: (313) 945-9188
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MICHIGAN SPECIALTY CLINIC PLLC is a specialist in Dearborn, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MICHIGAN SPECIALTY CLINIC PLLC NPI is 1760700660. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

13530 MICHIGAN AVE
SUITE 120
DEARBORN, MI
ZIP 48126-583
Phone: (313) 945-9188
Fax: (313) 945-9184

The provider's authorized official is Fatina Masri .
The authorized official title is Owner and has the following contact phone number (313) 945-9188.

The enumeration date for this NPI number is 5/17/2010 and was last updated on 3/10/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207YX0905XOtolaryngologyOtolaryngology/Facial Plastic SurgeryNo
2207Y00000XOtolaryngology4301052487MICHIGANNo
3207YS0012XOtolaryngologySleep MedicineNo
4207YX0007XOtolaryngologyPlastic Surgery within the Head & Neck4301052487MICHIGANNo
5208200000XPlastic Surgery4301052487MICHIGANNo
62086S0122XSurgeryPlastic and Reconstructive Surgery4301052487MICHIGANNo
7291U00000XClinical Medical LaboratoryNo
8174400000XSpecialistYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1700H269700OTHERBCN GROUP
2700H269700OTHERMICHIGANBCBS GROUP
31760800660MEDICAIDMICHIGAN
4DS8165OTHERMICHIGANRAILROAD MEDICARE

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.