NPIMap

Organization Active NPI

Premier Pediatrics

  • Pediatrics Physician
  • Dearborn Heights, MI
National Provider Identifier
1417407032
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101016795 Issued in MI
Legal business name
PREMIER PEDIATRICS
Practice address
22318 Ford Rd
Dearborn Heights, MI 48127-2421
Phone
(313) 278-2788
Fax
(313) 278-8215
NPI assigned
Oct 6, 2016
Last updated
Oct 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Dr. Mazen Naseeb Hamameh, DONPI 1215142153
Title
Member Physician
Phone
(313) 278-2788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101016795 MI Primary

Addresses

Primary practice location

22318 Ford Rd
Dearborn Heights, MI 48127-2421

Mailing address

22318 Ford Rd
Dearborn Heights, MI 48127-2421
Phone (313) 278-2788

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1417407032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22318 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272421",
            "telephone_number": "313-278-2788",
            "fax_number": "313-278-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22318 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272421",
            "telephone_number": "313-278-2788",
            "fax_number": "313-278-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "HAMAMEH",
        "authorized_official_first_name": "MAZEN",
        "authorized_official_middle_name": "NASEEB",
        "authorized_official_title_or_position": "MEMBER PHYSICIAN",
        "authorized_official_telephone_number": "313-278-2788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101016795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.