MEDICARE: DEARBORN MEDICAL WALKIN CLINIC

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	207Q00000X	Family Medicine Physician	4301040701	MI
2	2084P0800X	Psychiatry Physician	4301040701	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2648200032	OTHER	MI	BCBS PROVIDER ID
3	$$$$$$$$$	OTHER	MI	DR. CHAM SSN

General Provider Information

NPI Number	:	1821068537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEARBORN MEDICAL WALKIN CLINIC

Provider Business Mailing Address
First Line	:	2220 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-2213
Country	:	US
Telephone Number	:	313-563-4506
Fax Number	:	313-563-8443

Provider Business Practice Location Address
First Line	:	2220 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-2213
Country	:	US
Telephone Number	:	313-563-4506
Fax Number	:	313-563-8443

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SATISH KUMAR CHAM
Credential	:	MD
Telephone Number	:	313-563-7878

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	09/11/2025

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