Organization
PARAMOUNT MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GHAITH M IBRAHIM M.D. (PRESIDENT)
(586) 757-6400
Entity
Organization
Contact information
Practice address
27560 HOOVER RD, WARREN, MI 48093-4505
(586) 757-6400
(586) 757-0763
Mailing address
27560 HOOVER RD, WARREN, MI 48093-4505
(586) 757-6400
(586) 757-0763
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D2023134
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700E03492
BLUE CROSS
MI
Enumeration date
07/23/2013
Last updated
07/23/2013
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