Healthcare Provider Details

I. General information

NPI: 1225719693
Provider Name (Legal Business Name): ADVANCED MD SPECIALTY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16226 GRAND RIVER AVE
DETROIT MI
48227-1824
US

IV. Provider business mailing address

16226 GRAND RIVER AVE
DETROIT MI
48227-1824
US

V. Phone/Fax

Practice location:
  • Phone: 313-836-5490
  • Fax: 313-836-5224
Mailing address:
  • Phone: 313-836-5490
  • Fax: 313-836-5224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHADI SAAD
Title or Position: PRESIDENT
Credential: MD
Phone: 313-836-5490