Organization
CECELIA F. HISSONG, M. D., P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECELIA F. HISSONG M. D. (PRESIDENT)
(313) 563-5310
Entity
Organization
Contact information
Practice address
23100 CHERRY HILL RD., DEARBORN, MI 48124-1493
(313) 563-5310
(313) 563-8147
Mailing address
23100 CHERRY HILL RD., DEARBORN, MI 48124-1493
(313) 563-5310
(313) 563-8147
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CH027214
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080824144
BLUE CROSS BLUE SHIELD ID
MI
01
—
0824144
BLUE CARE NETWORK ID
MI
05
—
10/2095139
—
MI
01
—
126367
CARE CHOICES
MI
01
—
B44598
HAP ID
MI
01
—
C3390
M-CARE ID
MI
Enumeration date
10/31/2006
Last updated
12/22/2010
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