Provider Demographics
NPI:1457503674
Name:CHASE PEDIATRICS
Entity Type:Organization
Organization Name:CHASE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:AL-DAIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-581-9446
Mailing Address - Street 1:14650 W WARREN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1782
Mailing Address - Country:US
Mailing Address - Phone:313-581-9446
Mailing Address - Fax:313-581-9448
Practice Address - Street 1:14650 W WARREN AVE STE 300
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1782
Practice Address - Country:US
Practice Address - Phone:313-581-9446
Practice Address - Fax:313-581-9448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care