EXECUTIVE PLAZA MEDICAL P.C. NPI 1952715153

NPI Information

NPI: 1952715153
Provider Name: EXECUTIVE PLAZA MEDICAL, P.C.
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
17000 EXECUTIVE PLAZA DR
SUITE 103
DEARBORN, MI
ZIP 48126
Phone: (313) 915-4632
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EXECUTIVE PLAZA MEDICAL, P.C. is a multi-specialty clinic center in Dearborn, MI. EXECUTIVE PLAZA MEDICAL, P.C. NPI is 1952715153. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17000 EXECUTIVE PLAZA DR
SUITE 103
DEARBORN, MI
ZIP 48126-793
Phone: (313) 915-4632
Fax: (313) 915-4634

The provider's authorized official is Hossam A Hossein .
The authorized official title is Manager and has the following contact phone number (313) 915-4632.

The enumeration date for this NPI number is 6/16/2014 and was last updated on 1/13/2015.

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		5101006652	MICHIGAN	No
2	261QM1300X	Clinic/Center	Multi-Specialty	4301405559	MICHIGAN	No
3	261QM1300X	Clinic/Center	Multi-Specialty	4301405324	MICHIGAN	No
4	261QM1300X	Clinic/Center	Multi-Specialty	5101006652	MICHIGAN	Yes

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

NPI Synchronization or Removal

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