National Provider Identifier Database

MICHIGAN SPECIALTY CLINIC PLLC
Specialist

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.


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
* Specialist 174400000X
Clinical Medical Laboratory 291U00000X
Otolaryngology 207Y00000X
Otolaryngology/Facial Plastic Surgery 207YX0905X
Plastic and Reconstructive Surgery 2086S0122X
Plastic Surgery 208200000X
Plastic Surgery within the Head & Neck 207YX0007X
Sleep Medicine 207YS0012X

* Indicates primary specialty

NPI Profile & details for MICHIGAN SPECIALTY CLINIC PLLC

NPI Number 1760700660
Legal business name
LBN
MICHIGAN SPECIALTY CLINIC PLLC
Authorized official FATINA MASRI - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/17/2010
Last updated 03/10/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MI License #: 4301052487
  • MI Medicaid: 1760800660
  • Other: 700H269700 BCN GROUP
  • MI Other: 700H269700 BCBS GROUP
  • MI Other: DS8165 RAILROAD MEDICARE

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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