Healthcare Provider Details

I. General information

NPI: 1194892612
Provider Name (Legal Business Name): CARE PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N TELEGRAPH RD
DEARBORN MI
48128-1622
US

IV. Provider business mailing address

1022 N TELEGRAPH RD
DEARBORN MI
48128-1622
US

V. Phone/Fax

Practice location:
  • Phone: 313-274-6666
  • Fax: 313-274-4466
Mailing address:
  • Phone: 313-274-6666
  • Fax: 313-274-4466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301080518
License Number StateMI

VIII. Authorized Official

Name: DR. ALEX ELSABBAGH
Title or Position: OWNER
Credential: MD
Phone: 313-274-6666