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Organization

EASTBORN MEDICAL GROUP PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASSEM ELFAKIH MD (OWNER)
(313) 460-9965
Entity
Organization

Contact information

Practice address
15044 MICHIGAN AVE, DEARBORN, MI 48126-2914
(313) 460-9965
Mailing address
15044 MICHIGAN AVE, DEARBORN, MI 48126-2914
(313) 460-9965

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301089499
MI

Other

Enumeration date
10/19/2016
Last updated
10/25/2016
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