Organization
MICHIGAN SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAREK HADLA MD (MD)
(313) 562-4700
Entity
Organization
Contact information
Practice address
23902 FORD RD, SUITE A, DEARBORN HEIGHTS, MI 48127-3246
(313) 562-4700
(313) 562-4701
Mailing address
23902 FORD RD, SUITE A, DEARBORN HEIGHTS, MI 48127-3246
(313) 562-4700
(313) 562-4701
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
4301065806
MI
332B00000X
Durable Medical Equipment & Medical Supplies
4301095806
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28306
BCBS GRP
MI
05
—
1326481623
—
MI
01
—
6986550001
MEDICARE DME
MI
01
—
DU1788
RAILROAD MEDICARE
MI
Enumeration date
04/17/2013
Last updated
05/15/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us