Healthcare Provider Details

I. General information

NPI: 1427342625
Provider Name (Legal Business Name): TEL FORD MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 N TELEGRAPH RD
DEARBORN MI
48128-2213
US

IV. Provider business mailing address

2220 N TELEGRAPH RD
DEARBORN MI
48128-2213
US

V. Phone/Fax

Practice location:
  • Phone: 313-563-7878
  • Fax: 313-563-8443
Mailing address:
  • Phone: 313-563-7878
  • Fax: 313-563-8443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH SAAD
Title or Position: OWNER
Credential:
Phone: 313-563-7878