MICHIGAN SPECIALTY CLINIC PLLC; NPI #1760700660

Contact Information

MICHIGAN SPECIALTY CLINIC PLLC

13530 MICHIGAN AVE
SUITE 120
DEARBORN, MI 48126-3583

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

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NPI Profile & details for MICHIGAN SPECIALTY CLINIC PLLC

NPI # 1760700660

LBN Legal business name MICHIGAN SPECIALTY CLINIC PLLC

Authorized official FATINA MASRI - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/17/2010

Last updated 03/10/2020 - About 6 years ago

Identifiers

MI	License #	4301052487
MI	Medicaid	1760800660
	Other	700H269700	BCN GROUP
MI	Other	700H269700	BCBS GROUP
MI	Other	DS8165	RAILROAD MEDICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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MICHIGAN SPECIALTY CLINIC PLLC

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Specialty

NPI Profile & details for MICHIGAN SPECIALTY CLINIC PLLC

Reviews for MICHIGAN SPECIALTY CLINIC PLLC