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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
HASSAN DAKROUB M.D (MEDICAL DIRECTOR)
(313) 216-2230
Entity
Organization

Contact information

Practice address
6450 MAPLE, DEARBORN, MI 48126
(313) 216-2230
(313) 584-3206
Mailing address
2651 SAULINO CT, DEARBORN, MI 48209
(313) 842-7010
(313) 842-5150

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RI0200X
Infectious Disease Physician
4301087179
MI
208000000X
Pediatrics Physician
4301067792
MI
208000000X
Pediatrics Physician

Other

Enumeration date
07/21/2007
Last updated
04/01/2024
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