Advanced Care Center PLLC
Organization Active NPI Family Medicine Physician · Walled Lake, MI
NPI 1831996115 · NPPES record last updated Mar 24, 2026
Key facts
- NPI
- 1831996115
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ADVANCED CARE CENTER PLLC
- Practice address
- 1340 S Commerce Rd
Walled Lake, MI 48390-3010 - Phone
- (248) 438-6600
- Fax
- (248) 313-9210
- NPI assigned
- Feb 25, 2025
- Organization subpart
- No
Authorized official
- Name
- Mr. Moe Wilcox, MGR
- Title
- MGR
- Phone
- (419) 376-5856
Practitioners 1
-
Taleb Radwan Hage, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250516000680 | MI | Part B Supplier - Clinic/Group Practice | 6103344890 |
Receives reassigned benefits from 1 practitioner Practice locations: Dearborn Heights, MI; Lincoln Park, MI; Walled Lake, MI; Woodhaven, MI |
National Provider Directory
Locations
1340 S Commerce Rd
Walled Lake, MI 48390
Phone (248) 438-6600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1340 S Commerce Rd
Walled Lake, MI 48390-3010
Mailing address
1340 S Commerce Rd
Walled Lake, MI 48390-3010
Phone (248) 438-6600
Other practice location 1
3677 Fort St
Lincoln Park, MI 48146-4116
Phone (313) 254-2587
Other providers in Walled Lake, MI
- Aa Home Health Care, LLC
- Inaam Abdulkarim
- Ad Behavioral Health Services LLC
- Advanced Urgent Care Center
- Alaa Primary Care PLLC
- Jenelle Zvoch Allen
- Troy L Amber
- Amy Lois Anderson
All providers in Walled Lake, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.