Provider Demographics
NPI:1174995203
Name:DEARBORN PAIN CENTER PLLC
Entity type:Organization
Organization Name:DEARBORN PAIN CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOATAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-629-7497
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-0365
Mailing Address - Country:US
Mailing Address - Phone:248-629-7497
Mailing Address - Fax:248-397-8474
Practice Address - Street 1:624 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-1842
Practice Address - Country:US
Practice Address - Phone:248-629-7497
Practice Address - Fax:248-397-8474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty