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General NPI Number Information
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NPI Number | 1619298221
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Entity Type | Organization
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Legal Business Name | GREENFIELD MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 6050 GREENFIELD RD
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City | DEARBORN
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State | MI
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Zip | 48126-6004
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Country | US
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Telephone | 248-470-5363
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Fax |
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Provider Business Mailing Address
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Address Line | 6050 GREENFIELD RD
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City | DEARBORN
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State | MI
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Zip | 48126-6004
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Country | US
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Telephone | 248-470-5363
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. AMAL ABDUL-HUSSEIN
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Credential | M.D
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Telephone | 248-470-5363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301086669
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License Number State | MI
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