MEDICARE: ADVANCED MD SPECIALTY CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1225719693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MD SPECIALTY CARE PLLC

Provider Business Mailing Address
First Line	:	16226 GRAND RIVER AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1824
Country	:	US
Telephone Number	:	313-836-5490
Fax Number	:	313-836-5224

Provider Business Practice Location Address
First Line	:	16226 GRAND RIVER AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1824
Country	:	US
Telephone Number	:	313-836-5490
Fax Number	:	313-836-5224

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHADI SAAD
Credential	:	MD
Telephone Number	:	313-836-5490

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	04/25/2024

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