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Contact Information

MICHIGAN SPECIALTY CLINIC PLLC
13530 MICHIGAN AVE
SUITE 120
DEARBORN, MI48126-3583
 Phone: 313-945-9188
 Fax: 313-945-9184
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Otolaryngology/Facial Plastic Surgery

207YX0905X 04 Physician/Otolaryngology
 

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
 

Plastic Surgery

208200000X 02 Physician/General Surgery
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
 

Sleep Medicine

207YS0012X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MICHIGAN SPECIALTY CLINIC PLLC · (Female)

NPI # 1760700660
Status Active
Credentials
Entity Individual
Enumeration date 05/17/2010
Last updated 03/10/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 4301052487
  • MI Medicaid 1760800660
  • Other 700H269700 BCN GROUP
  • MI Other 700H269700 BCBS GROUP
  • MI Other DS8165 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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