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NPI Code Detail

MEDICARE: PRIMARY CARE CENTER PLLC

MEDICARE: PRIMARY CARE CENTER PLLC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1780292623
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY CARE CENTER PLLC
Provider Business Mailing Address
First Line : 3902 MONROE ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48125-2545
Country : US
Telephone Number : 313-562-1985
Fax Number : 313-562-0380
Provider Business Practice Location Address
First Line : 3902 MONROE ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48125-2545
Country : US
Telephone Number : 313-562-1985
Fax Number : 313-562-0380
Authorized Official
Title or Position : SOLE MBR
Name : DR. NAIFF ALI
Credential : MD
Telephone Number : 313-932-0185
Provider Enumeration Date : 07/16/2020
Last Update Date : 08/09/2022

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