# EXECUTIVE MEDICAL CARE LLC

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

## Provider details

- **NPI number:** 1629775580
- **Authorized official:** HASSAN ISMAIL (AO)
- **Authorized official phone:** (419) 890-4666

## Contact information

- **Practice address:** 4260 MONROE ST, TOLEDO, OH 43606-1944
- **Practice address phone:** (419) 890-4666
- **Mailing address:** 17000 EXECUTIVE PLAZA DR STE 201, DEARBORN, MI 48126-2793
- **Mailing address phone:** (419) 890-4666
- **Mailing address fax:** (419) 890-4771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/10/2023
- **Last updated:** 08/29/2023