Provider Demographics
NPI:1912097734
Name:DEARBORN HEIGHTS MEDICAL CENTER P C
Entity Type:Organization
Organization Name:DEARBORN HEIGHTS MEDICAL CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IMAN
Authorized Official - Middle Name:FAKIH
Authorized Official - Last Name:ELMENINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-792-0000
Mailing Address - Street 1:25516 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3022
Mailing Address - Country:US
Mailing Address - Phone:313-792-0000
Mailing Address - Fax:313-359-9333
Practice Address - Street 1:25516 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3022
Practice Address - Country:US
Practice Address - Phone:313-792-0000
Practice Address - Fax:313-359-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility