# DEARBORN NURO CLINIC PC

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

## Provider details

- **NPI number:** 1568638088
- **Authorized official:** BASSAM MAAZ MD (PRESIDENT)
- **Authorized official phone:** (313) 724-9584

## Contact information

- **Practice address:** 25325 FORD RD, SUITE 100, DEARBORN, MI 48128-1086
- **Practice address phone:** (313) 724-0584
- **Mailing address:** 25325 FORD RD, SUITE 100, DEARBORN, MI 48128-1086
- **Mailing address phone:** (313) 724-0584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 4301053885 | MI | Yes |

## Other

- **Enumeration date:** 05/05/2008
- **Last updated:** 05/05/2008