Michigan Sports Medicine Pc

LBN: Michigan Sports Medicine Pc
Michigan Sports Medicine Pc is an health care organization with primary practice located at 23902 Ford Rd Suite A, Dearborn Heights MI 48127-3246. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Sports Medicine is the primary health care specialty. Michigan Sports Medicine Pc can be contacted via phone (313) 562-4700, or through Hadla, Tarek via phone (313) 562-4700.

Contact Information

Primary practice address
23902 Ford Rd Suite A Dearborn Heights MI 48127-3246
Phone: (313) 562-4700
Fax: (313) 562-4701
Website:
Map and Directions
Authorized official contact:
Name: Hadla, Tarek Doctor of Medicine (MD)
Phone: (313) 562-4700

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 4301065806 Michigan
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 4301095806 Michigan

Profile Details

NPI number 1326481623
LBN Legal business name Michigan Sports Medicine Pc
DBA Doing business as
Authorized official Hadla, Tarek Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 17th, 2013
Last updated May 15th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326481623 NPPES
Michigan Other 0H28306 BCBS GRP
Michigan Other DU1788 BCBS GRP
Michigan Other 0H28306 BCBS GRP
Michigan MEDICAID 1326481623 BCBS GRP
Michigan Other 6986550001 BCBS GRP

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