MICHIGAN SPECIALTY CLINIC PLLC (NPI# 1760700660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760700660 |
| Entity Type | Organization |
| Organization Name | MICHIGAN SPECIALTY CLINIC PLLC |
| Practice Address |
13530 Michigan Ave Suite 120 Dearborn MI 48126-3583 |
| Mailing Address |
13530 Michigan Ave Ste 400 Dearborn MI 48126-3575 |
| Practice Telephone | 3139459188 |
| Practice Fax Number | 3139459184 |
| Mailing Telephone | 3139459188 |
| Mailing Fax Number | 3139459184 |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | DR. FATINA MASRI (OWNER) |
| Authorized Official Telephone | 3139459188 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | 4301052487 | MI | Allopathic & Osteopathic Physicians |
| N | 207YS0012X |
Otolaryngology Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
4301052487 | MI | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | 4301052487 | MI | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
4301052487 | MI | Allopathic & Osteopathic Physicians |
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCN GROUP | 700H269700 | 01 | |
| MI | BCBS GROUP | 700H269700 | 01 |
| MI | 1760800660 | 05 | |
| MI | RAILROAD MEDICARE | DS8165 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730646977 | Michigan Specialty Clinic Pllc | Clinic/Center | 13510 Michigan Ave, Dearborn, MI 48126-3511 | 2019-02-25 |
| 1295247633 | Michigan Specialty Clinic Pllc | Clinic/Center | 13510 Michigan Ave, Dearborn, MI 48126-3511 | 2017-10-25 |
| 1457882888 | Michigan Specialty Clinic Pllc | Clinical Medical Laboratory | 13530 Michigan Ave, Suite L2, Dearborn, MI 48126-3574 | 2017-03-27 |
| Street Address |
13530 MICHIGAN AVE SUITE 120 |
| City | DEARBORN |
| State | MI |
| Zip Code | 48126-3583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225020043 | Manijeh Shafiemir | Optometrist | 13530 Michigan Ave, Dearborn, MI 48126-3574 | 2005-08-17 |
| 1437776689 | Neurospine Coverage Pllc | Psychiatry & Neurology | 13530 Michigan Ave, Dearborn, MI 48126-3574 | 2020-07-02 |
| 1831758358 | Bashir D Tarraf | Optometrist | 13530 Michigan Ave, Dearborn, MI 48126-3574 | 2019-06-08 |
| 1538694054 | Hs Management LLC | Clinic/Center | 13530 Michigan Ave, Ground Floor, Dearborn, MI 48126-3574 | 2017-04-21 |
| 1457882888 | Michigan Specialty Clinic Pllc | Clinical Medical Laboratory | 13530 Michigan Ave, Suite L2, Dearborn, MI 48126-3574 | 2017-03-27 |
| 1902347529 | Nextgen Diagnostics LLC | Radiology | 13530 Michigan Ave, Ste 101, Dearborn, MI 48126-3574 | 2017-03-15 |
| 1790226314 | Nextgen Pain Associates & Rehabilitation LLC | Clinic/Center | 13530 Michigan Ave, Ste 310, Dearborn, MI 48126-3574 | 2017-03-15 |
| 1487192662 | Healthcare Durable Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 13530 Michigan Ave, Suite L2, Dearborn, MI 48126-3574 | 2017-02-07 |
| 1063964609 | Nextgen Rehab LLC | Pain Medicine | 13530 Michigan Ave, Suite 310, Dearborn, MI 48126-3574 | 2016-10-31 |
| 1851842157 | Dearborn Pain Specialists, Plc | Pain Medicine | 13530 Michigan Ave, Suite 245, Dearborn, MI 48126-3574 | 2016-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323303 | Aq Dental Group Pllc | Clinic/Center | 10413 Ford Road, Units M & N, Dearborn, MI 48126 | 2020-10-12 |
| 1275148165 | Anasthesia Pain Service PC | Clinic/Center | 15350 Michigan Ave, Dearborn, MI 48126 | 2020-09-09 |
| 1417501958 | Ximena Noemi Ortega | Behavior Technician | 6241 Miller Rd, Dearborn, MI 48126 | 2019-08-01 |
| 1912478827 | Abar Alghazali | Behavior Technician | 4641 Lois, Dearborn, MI 48126 | 2018-12-17 |
| 1861972457 | Laboratory Specialists of Michigan, LLC | Clinical Medical Laboratory | 13530 Michigan Ave Ste 240, Dearborn, MI 48126 | 2018-08-14 |
| 1528544806 | Farah Osman | Pharmacist | 14715 Ford Rd, Dearborn, MI 48126 | 2018-07-19 |
| 1255821328 | Loyal Pharmacy LLC | Pharmacy | 7118 Greenfield Rd St(b), Dearborn, MI 48126 | 2018-05-15 |
| 1952803900 | Neetika Kesar | Physical Therapist | 15051, Ford Road, Dearborn, MI 48126 | 2018-03-06 |
| 1396247607 | David Jerome Kurcz | Physical Therapy Assistant | 15051 Ford Road, Henry Ford Village, Dearborn, MI 48126 | 2018-03-02 |
| 1043732506 | Shadiya Ahmed | Dentist | 4700 Schaefer Rd Ste 190, Dearborn, MI 48126 | 2017-07-16 |
| Find all providers in zip 48126 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568889251 | Independent Medical Associates PC | Specialist | 24825 Michigan Ave Ste B, Dearborn, MI 48124-1758 | 2014-03-20 |
| 1740544550 | Angela Patricia - Galeano Carlson | Specialist | 23910 Oak St, Dearborn, MI 48128-2202 | 2012-06-26 |
| 1427239458 | William G Nutting M.d.p.c. | Specialist | 1637 Monroe St, Dearborn, MI 48124-2912 | 2007-11-19 |
| 1548463151 | Susan Kusner | Specialist | 13020 Osborne St, Dearborn, MI 48126-3640 | 2007-06-10 |
| 1194859314 | Darapen C Chivalak | Specialist | 1640 Monroe St, Dearborn, MI 48124-2913 | 2007-03-16 |
| 1821159690 | Kirsten Clark | Specialist | 20031 Carlysle St, Suite 3, Dearborn, MI 48124-3803 | 2006-12-13 |
| 1306880471 | Hyun Sik Chang | Specialist | 3815 Pelham, Suite 5, Dearborn, MI 48124-3852 | 2006-06-16 |
| 1184664302 | John J. Bernick | Specialist | 751 S Military St, Dearborn, MI 48124-2107 | 2006-06-07 |
| 1710943683 | Peter L. Stevenson, Md, PC | Specialist | 2100 Monroe Street, Dearborn, MI 48124 | 2006-04-21 |
| 1134195480 | Raghda Chwikani | Specialist | 10326 W Warren Ave, Dearborn, MI 48126-1659 | 2006-02-27 |
| Find all providers in DEARBORN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.