Healthcare Provider Details

I. General information

NPI: 1083294052
Provider Name (Legal Business Name): FAMILY DOC URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25350 W WARREN ST
DEARBORN HEIGHTS MI
48127-2102
US

IV. Provider business mailing address

25350 W WARREN ST
DEARBORN HEIGHTS MI
48127-2102
US

V. Phone/Fax

Practice location:
  • Phone: 313-914-3666
  • Fax: 313-380-0672
Mailing address:
  • Phone: 313-914-3666
  • Fax: 313-380-0672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALI IBRAHIM NASRALLAH
Title or Position: PRESIDENT
Credential: MD
Phone: 313-914-3666