Healthcare Provider Details

I. General information

NPI: 1083810444
Provider Name (Legal Business Name): MIDWEST HEALTH CENTER-DEARBORN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 SCHAEFER RD
DEARBORN MI
48126-3249
US

IV. Provider business mailing address

5050 SCHAEFER RD
DEARBORN MI
48126-3249
US

V. Phone/Fax

Practice location:
  • Phone: 313-586-6013
  • Fax: 313-581-0228
Mailing address:
  • Phone: 313-586-6013
  • Fax: 313-581-0228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAFFER MARK B
Title or Position: CEO
Credential: DPM
Phone: 313-586-6038