Healthcare Provider Details

I. General information

NPI: 1538761937
Provider Name (Legal Business Name): PRIORITY MEDICAL CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12170 CONANT ST STE C2
HAMTRAMCK MI
48212-4137
US

IV. Provider business mailing address

12170 CONANT ST STE C2
HAMTRAMCK MI
48212-4137
US

V. Phone/Fax

Practice location:
  • Phone: 313-893-6218
  • Fax:
Mailing address:
  • Phone: 313-893-6218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AHMAD GHABSHA
Title or Position: OWNER
Credential: MD
Phone: 313-893-6218