# JUAN A. ESTIGARRIBIA M.D. PC.

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

## Provider details

- **NPI number:** 1760651012
- **Authorized official:** DR. JUAN ANGEL ESTIGARRIBIA MD. (PRESIDENT)
- **Authorized official phone:** (313) 277-0075

## Contact information

- **Practice address:** 23550 PARK ST STE 201, DEARBORN, MI 48124-2592
- **Practice address phone:** (313) 277-0075
- **Practice address fax:** (313) 277-8029
- **Mailing address:** 23550 PARK ST STE 201, DEARBORN, MI 48124-2592
- **Mailing address phone:** (313) 277-0075
- **Mailing address fax:** (313) 277-8029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | JE038833 | MI | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 02/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0823594 | BCBS | MI |
| 05 | — | 2120269 | — | MI |