Healthcare Provider Details

I. General information

NPI: 1700841475
Provider Name (Legal Business Name): DEARBORN SURGICAL ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18181 OAKWOOD BLVD SUITE 209
DEARBORN MI
48124-5032
US

IV. Provider business mailing address

18181 OAKWOOD BLVD SUITE 209
DEARBORN MI
48124-5032
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-8560
  • Fax: 313-271-2831
Mailing address:
  • Phone: 313-271-8560
  • Fax: 313-271-2831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES RANDOLPH LULEK
Title or Position: PRESIDENT/GENERAL/VASCULAR SURGEON
Credential: M.D.
Phone: 313-271-8560