Healthcare Provider Details
I. General information
NPI: 1386680502
Provider Name (Legal Business Name): ADVANCED MEDICAL CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2006
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4132 SCHAEFER RD
DEARBORN MI
48126-3683
US
IV. Provider business mailing address
10140 W VERNOR HIGHWAY
DEARBORN MI
48120
US
V. Phone/Fax
- Phone: 313-849-3100
- Fax: 313-899-7099
- Phone: 313-849-3100
- Fax: 313-899-7099
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SALEH
MUSLAH
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 313-849-3100