DEARBORN ALLERGY & ASTHMA CLINIC PC (NPI# 1477545200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477545200 |
| Entity Type | Organization |
| Organization Name | DEARBORN ALLERGY & ASTHMA CLINIC PC |
| Practice Address |
20200 Outer Dr Dearborn MI 48124-2634 |
| Practice Telephone | 3135653565 |
| Practice Fax Number | 3135657723 |
| Mailing Telephone | 3135653565 |
| Mailing Fax Number | 3135657723 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2012-04-24 |
| Authorized Official Name | MRS. KATHY SHORT (OFFICE MANAGER) |
| Authorized Official Telephone | 3135653565 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KI0005X |
Allergy & Immunology Specialization: Clinical & Laboratory Immunology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1083483 | 05 | |
| MI | 1290003 | 05 | |
| MI | BLUE CROSS | 0H26340 | 01 |
| MI | 2838806 | 05 |
| Street Address |
20200 OUTER DR |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-2634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083854095 | Premier Cardiovascular Specialists PC | Internal Medicine | 20200 Outer Dr, Dearborn, MI 48124-2634 | 2009-03-03 |
| 1992773766 | Ilie Magdea | Allergy & Immunology | 20200 Outer Dr, Dearborn, MI 48124-2634 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 207KI0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Clinical & Laboratory Immunology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215905765 | James G Fordyce | Allergy & Immunology | 19855 Outer Dr, Ste 204, Dearborn, MI 48124-2022 | 2006-03-10 |
| 1750359204 | Diane L Baranowski | Allergy & Immunology | 19855 Outer Dr, Ste 204, Dearborn, MI 48124-2022 | 2006-03-10 |
| 1992773766 | Ilie Magdea | Allergy & Immunology | 20200 Outer Dr, Dearborn, MI 48124-2634 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497735310 | Ridhu Chopra Burton | Allergy & Immunology | 4169 Legacy Pkwy, Lansing, MI 48911-4258 | 2006-01-18 |
| 1649234980 | Paragon Health, P.C. | Allergy & Immunology | 430 W Centre Ave, Portage, MI 49024-5304 | 2006-04-13 |
| 1689645103 | James H. Saker | Allergy & Immunology | 4169 Legacy Pkwy, Lansing, MI 48911-4258 | 2006-02-01 |
| 1861472797 | Clyde R. Flory Jr. | Allergy & Immunology | 4169 Legacy Pkwy, Lansing, MI 48911-4258 | 2006-01-18 |
Please comment or provide details below to improve the information on DEARBORN ALLERGY & ASTHMA CLINIC PC.
| 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.