# MICHIGAN PRIMARY CARE CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205312428
- **Authorized official:** DR. RODWAN FADLALLAH MD (PRESIDENT)
- **Authorized official phone:** (313) 406-2222

## Contact information

- **Practice address:** 27250 CHERRY HILL RD, DEARBORN HEIGHTS, MI 48127-3677
- **Practice address phone:** (313) 406-2222
- **Practice address fax:** (313) 908-2687
- **Mailing address:** 27250 CHERRY HILL RD, DEARBORN HEIGHTS, MI 48127-3677
- **Mailing address phone:** (313) 406-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 4301103085 | MI | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 07/11/2018
- **Last updated:** 02/22/2023