=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124973052
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PLATINUM PRIMARY CARE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2026
-----------------------------------------------------
Last Update Date | 03/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23420 FORD RD STE 100
-----------------------------------------------------
City | DEARBORN HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48127-2396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-203-5310
-----------------------------------------------------
Fax | 313-914-2529
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23420 FORD RD STE 100
-----------------------------------------------------
City | DEARBORN HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48127-2396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-203-5310
-----------------------------------------------------
Fax | 313-914-2529
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | C.O.O.
-----------------------------------------------------
Name | ERIC ALZAROUI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 313-203-5300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------