Michigan Specialty Clinic PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MICHIGAN SPECIALTY CLINIC PLLC

Practice address

13530 Michigan Ave
Suite 120
Dearborn, MI 48126-3583

Phone

(313) 945-9188

Fax

(313) 945-9184

NPI assigned

May 17, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Fatina Masri, M.D.

Title

Owner

Phone

(313) 945-9188

Specialties & licenses 8

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1760700660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 MICHIGAN AVE STE 400",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263575",
            "telephone_number": "313-945-9188",
            "fax_number": "313-945-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 MICHIGAN AVE",
            "address_2": "SUITE 120",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263583",
            "telephone_number": "313-945-9188",
            "fax_number": "313-945-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SPECIALTY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-17",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "MASRI",
        "authorized_official_first_name": "FATINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-945-9188",
        "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
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301052487",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "MI",
            "license": "4301052487",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301052487",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MI",
            "license": "4301052487",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "700H269700",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760800660",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "700H269700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DS8165",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Sleep Center PLLC
• Michigan Sleep Lab
• Michigan Specialty Clinic PLLC
• Michigan Specialty Clinic PLLC
• Michigan Specialty Clinic PLLC
• Michigan Specialty Clinic PLLC
• Michigan Spine Management Clinic PLC
• Michigan Surgery Specialists, P.C.
• Michigan Surgery Specialists, P.C.
• Michigan Technology Partners LLC

• 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 10, 2020; 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.