=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568639656
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY MEDICAL CARE PLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2008
-----------------------------------------------------
Last Update Date | 05/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10218 JOSEPH CAMPAU ST
-----------------------------------------------------
City | HAMTRAMCK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48212-3224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-872-6000
-----------------------------------------------------
Fax | 313-899-7099
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1071
-----------------------------------------------------
City | DEARBORN HTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48127-7071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-872-6000
-----------------------------------------------------
Fax | 313-899-7099
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SALEH MUSLAH SALEH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 313-872-6000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number | SM052435
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------