Organization
EASTBORN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMIN S HUBALLAH PA-C (PHYSICIAN ASSISTANT)
(313) 834-4444
Entity
Organization
Contact information
Practice address
7526 WYOMING ST, STE# 2, DEARBORN, MI 48126-1690
(313) 834-4444
Mailing address
7526 WYOMING ST, SUITE NUMBER 2, DEARBORN, MI 48126-1690
(313) 834-4444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5601005284
MI
Other
Enumeration date
01/18/2013
Last updated
04/30/2014
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