Organization
J & I PEDIATRIC CARE CENTER
Active
Other names
Pediatric Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANAL N HADDAD (OFFICE MANAGER)
(313) 841-1680
Entity
Organization
Contact information
Practice address
9720 DIX, DEARBORN, MI 48120-1566
(313) 841-1680
Mailing address
9720 DIX, DEARBORN, MI 48120-1566
(313) 841-1680
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350H211870
BCBSM GROUP NUMBER
MI
Enumeration date
03/30/2007
Last updated
02/06/2020
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