MEDICARE: DAGHER 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	207R00000X	Internal Medicine Physician
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1629721204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAGHER PLLC

Provider Business Mailing Address
First Line	:	2035 MONROE ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2920
Country	:	US
Telephone Number	:	313-438-6052
Fax Number	:	313-789-8545

Provider Business Practice Location Address
First Line	:	2035 MONROE ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2920
Country	:	US
Telephone Number	:	313-438-6052
Fax Number	:	313-789-8545

Authorized Official
Title or Position	:	OWNER
Name	:	BATOUL DAGHER
Credential	:	DO
Telephone Number	:	313-213-4465

Provider Enumeration Date	:	02/02/2022
Last Update Date	:	02/02/2022

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