Healthcare Provider Details
I. General information
NPI: 1902003759
Provider Name (Legal Business Name): MIDWEST HEALTH CENTER-METRO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5050 SCHAEFER RD
DEARBORN MI
48126-3249
US
IV. Provider business mailing address
DETROIT METROPOLITAN AIRPORT BLDG 533 E. SERVICE DRIVE
DETROIT MI
48242
US
V. Phone/Fax
- Phone: 313-586-6013
- Fax: 313-581-0228
- Phone: 734-941-1000
- Fax: 734-941-9836
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | |
| License Number State | MI |
VIII. Authorized Official
Name:
MARK
B
SAFFER
Title or Position: CEO
Credential: DPM
Phone: 313-586-6038