NPIMap

Organization Active NPI

SD Cardiovascular P C

  • Cardiovascular Disease Physician
  • Dearborn, MI
National Provider Identifier
1225312895
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301038418 Issued in MI
Legal business name
SD CARDIOVASCULAR P C
Practice address
22060 Beech St
Suite 200
Dearborn, MI 48124-2847
Phone
(313) 563-3640
Fax
(313) 724-1885
NPI assigned
Sep 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Authorized official

Name
Dr. Samir Abdallah Dabbous, M.D.
Title
President
Phone
(313) 563-3640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 4301038418 MI Primary

Addresses

Primary practice location

22060 Beech St
Suite 200
Dearborn, MI 48124-2847

Mailing address

22060 Beech St
Suite 200
Dearborn, MI 48124-2847
Phone (313) 563-3640

Other identifiers 2

IdentifierTypeStateIssuer
0H27352OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
DS2983OtherMIMEDICARE RAILROAD

Other names 1

  • Dearborn Cardiology Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369008000000",
    "number": "1225312895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22060 BEECH ST",
            "address_2": "SUITE 200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242847",
            "telephone_number": "313-563-3640",
            "fax_number": "313-724-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22060 BEECH ST",
            "address_2": "SUITE 200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242847",
            "telephone_number": "313-563-3640",
            "fax_number": "313-724-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD CARDIOVASCULAR P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2013-05-20",
        "status": "A",
        "authorized_official_last_name": "DABBOUS",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "ABDALLAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-563-3640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301038418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "0H27352",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DS2983",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dearborn Cardiology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.