Michigan Primary Care Center PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301103085 Issued in MI

Legal business name

MICHIGAN PRIMARY CARE CENTER PC

Practice address

27250 Cherry Hill Rd
Dearborn Heights, MI 48127-3677

Phone

(313) 406-2222

Fax

(313) 908-2687

NPI assigned

Jul 11, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rodwan Fadlallah, MDNPI 1255772604

Title

President

Phone

(313) 406-2222

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rodwan Fadlallah, M.D.

  • Internal Medicine Physician
  • Dearborn Heights, MI
  • NPI 1255772604
  Medicare reassignment NPD Authorized official
• Nour Makhzoum

  • Medical Physician Assistant
  • Redford, MI
  • NPI 1205379633
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1205312428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27250 CHERRY HILL RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273677",
            "telephone_number": "313-406-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27250 CHERRY HILL RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273677",
            "telephone_number": "313-406-2222",
            "fax_number": "313-908-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PRIMARY CARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "FADLALLAH",
        "authorized_official_first_name": "RODWAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-406-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301103085",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Dental Associates II PC
• Michigan First Medical Group PLC
• Michigan First Urgent Care PLC
• Michigan Glaucoma Institute PC
• Michigan Institute of Vascular and Interventional Radiology, PLLC
• Michigan Rehabilitation Center LLC
• Michigan Sleep Network, P.C.
• Michigan Sports Medicine PC
• Michigan Sports Medicine PC
• Michigan Therapeutic Solutions, Inc.

• Internal Medicine Physician in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.