Alsan Medical Clinic P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ALSAN MEDICAL CLINIC P.C.

Practice address

3130 Gratiot Ave
Detroit, MI 48207-2283

Phone

(313) 579-1860

Fax

(313) 579-0017

NPI assigned

Apr 10, 2007

Last updated

May 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jacqueline Graham

Title

Office Manager

Phone

(313) 579-1860

Specialties & licenses 1

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

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christina Louise Clark, M.D.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1467515171
  Medicare reassignment
• Frank M Clark, DO

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1831105782
  Medicare reassignment

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1235352345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072283",
            "telephone_number": "313-579-1860",
            "fax_number": "313-579-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072283",
            "telephone_number": "313-579-1860",
            "fax_number": "313-579-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALSAN MEDICAL CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-579-1860",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamel Alsaedi
• Ragad Alsaeed
• Bushra Alsafari
• Mohamed Alsafari
• Aisha Alsaisi
• Lianna Alscher
• Khaled Alshabani, M.D.
• Taghreed Alshaeri, M.D.
• Mohammad T M T Alshamali, MD
• Sami Alshami, PHARMACIST

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.