# ADVANCED FAMILY CLINIC PLLC

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

## Provider details

- **NPI number:** 1629601745
- **Authorized official:** HAISSAM GHALEB EL-TAKECH SAMIRA DGHAILY (OFFICE MANAGER)
- **Authorized official phone:** (313) 632-1351

## Contact information

- **Practice address:** 6636 N TELEGRAPH RD, DEARBORN HEIGHTS, MI 48127-2200
- **Practice address phone:** (313) 274-3123
- **Practice address fax:** (313) 274-3343
- **Mailing address:** 6636 N TELEGRAPH RD, DEARBORN HEIGHTS, MI 48127-2200
- **Mailing address phone:** (313) 632-1349
- **Mailing address fax:** (313) 274-3343

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2020
- **Last updated:** 02/17/2020