DEARBORN PEDIATRIC & ADOLESCENT MEDICAL CENTER, PC
Ambulatory Health at Schaefer Rd, Dearborn, MI

License number
Michigan 4301064108
Category
Ambulatory Health
Type
Primary Care
Owner
Name: LOBNA R ELHASAN-FAKIH M.D.
Title: PRESIDENT
Phone: (313) 582-3700
Address
Address
6620 Schaefer Rd, Dearborn, MI 48126
National Provider ID: 1427056068
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DEARBORN PEDIATRIC & ADOLESCENT MEDICAL CENTER, PC

Dearborn, MI

Registration:
Apr 28, 1998
Addresses:
6620 Schaefer, Dearborn, MI 48126 (Physical)
3 Parklane Blvd #107, Dearborn, MI 48126 (Mailing)
State ID:
531304
Business type:
Domestic Professional Service Corporation
Agent:
Dr Lobna Fakih

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