Organization
CHILDRENS HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAGHDA CHWIKANI M.D (MEDICAL DIRECTOR)
(313) 581-2064
Entity
Organization
Contact information
Practice address
10326 W WARREN AVE, DEARBORN, MI 48126-1659
(313) 581-2064
(313) 581-3590
Mailing address
10326 W WARREN AVE, DEARBORN, MI 48126-1659
(313) 581-2064
(313) 581-3590
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
4301056496
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3180397
—
MI
01
—
3508255982
BCBSM
MI
01
—
700H219830
BLUE CARE NEWWORK
MI
Enumeration date
04/10/2008
Last updated
08/29/2023
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