Healthcare Provider Details

I. General information

NPI: 1467732644
Provider Name (Legal Business Name): APEX BEHAVIORAL HEALTH DEARBORN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PARKLANE BLVD SUITE 695
DEARBORN MI
48126-2696
US

IV. Provider business mailing address

6 PARKLANE BLVD SUITE 695
DEARBORN MI
48126-2696
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-8170
  • Fax: 313-271-8353
Mailing address:
  • Phone: 313-271-8170
  • Fax: 313-271-8353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301040442
License Number StateMI

VIII. Authorized Official

Name: DR. GHULAM QADIR
Title or Position: CEO
Credential: MD
Phone: 313-271-8170