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General NPI Number Information
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NPI Number | 1598319147
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Entity Type | Organization
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Legal Business Name | CRESCENT PROCEDURE CENTER PLC
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 30671 STEPHENSON HWY STE A
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-1635
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Country | US
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Telephone | 586-445-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 30671 STEPHENSON HWY STE A
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-1635
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Country | US
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Telephone | 586-445-9900
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | NABIL BEYDOUN
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Credential |
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Telephone | 313-414-8673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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