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Specialty details in registry · Dearborn, MI

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At a glance

6450 Maple St, Dearborn, MI 48126-2259

NPPES record updated Mar 1, 2017. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

6450 Maple St
Dearborn, MI 48126-2259
Professional details: NPI, taxonomy & registry record
NPI1861932550
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
251S00000X
Enumeration date
Mar 1, 2017
Record updated
Mar 1, 2017
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251S00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

6450 Maple St
Dearborn, MI 48126-2259
Phone
(313) 216-2202
Fax
(313) 584-3622
Mailing address
6450 MAPLE ST

DEARBORN, MI 481262259
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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