=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376383885
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CORE HEALTHCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2024
-----------------------------------------------------
Last Update Date | 01/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7601 WYOMING ST RM 1
-----------------------------------------------------
City | DEARBORN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48126-1638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-899-0994
-----------------------------------------------------
Fax | 248-750-8546
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 233
-----------------------------------------------------
City | DEARBORN HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48127-0233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-899-0994
-----------------------------------------------------
Fax | 586-204-0396
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | MOHAMAD A SADEK
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 734-899-0994
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------