Organization
SD CARDIOVASCULAR P C
Active
Other names
Dearborn Cardiology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMIR ABDALLAH DABBOUS M.D. (PRESIDENT)
(313) 563-3640
Entity
Organization
Contact information
Practice address
22060 BEECH ST, SUITE 200, DEARBORN, MI 48124-2847
(313) 563-3640
(313) 724-1885
Mailing address
22060 BEECH ST, SUITE 200, DEARBORN, MI 48124-2847
(313) 563-3640
(313) 724-1885
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301038418
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H27352
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
—
DS2983
MEDICARE RAILROAD
MI
Enumeration date
09/30/2011
Last updated
05/20/2013
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