MEDICARE: TEL FORD MEDICAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1427342625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEL FORD MEDICAL PC

Provider Business Mailing Address
First Line	:	2220 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-2213
Country	:	US
Telephone Number	:	313-563-7878
Fax Number	:	313-563-8443

Provider Business Practice Location Address
First Line	:	2220 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-2213
Country	:	US
Telephone Number	:	313-563-7878
Fax Number	:	313-563-8443

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOSEPH SAAD
Credential	:
Telephone Number	:	313-563-7878

Provider Enumeration Date	:	06/06/2011
Last Update Date	:	06/06/2011

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