Independent Medical Associates PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

INDEPENDENT MEDICAL ASSOCIATES PC

Practice address

24825 Michigan Ave Ste B
Dearborn, MI 48124-1758

Phone

(313) 565-3365

Fax

(313) 565-3440

NPI assigned

Mar 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ali Kaddoura, M.D

Title

Leader

Phone

(313) 565-3365

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396224000000",
    "number": "1568889251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24825 MICHIGAN AVE STE B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241758",
            "telephone_number": "313-565-3365",
            "fax_number": "313-565-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24825 MICHIGAN AVE STE B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241758",
            "telephone_number": "313-565-3365",
            "fax_number": "313-565-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-31",
        "status": "A",
        "authorized_official_last_name": "KADDOURA",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "LEADER",
        "authorized_official_telephone_number": "313-565-3365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.