Organization Active NPI

Ahmad Al Dabagh, M.D., P.C.

  • Internal Medicine Physician
  • Flint, MI
National Provider Identifier
1851314256
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301063880 Issued in MI
Legal business name
AHMAD AL DABAGH, M.D., P.C.
Practice address
5084 Villa Linde Pkwy
Suite 5
Flint, MI 48532-3422
Phone
(810) 733-8105
Fax
(810) 733-8135
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Authorized official

Name
Ahmad Al Dabagh, M.D.
Title
President Owner
Phone
(810) 733-8105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301063880 MI Primary

Addresses

Primary practice location

5084 Villa Linde Pkwy
Suite 5
Flint, MI 48532-3422

Mailing address

5084 Villa Linde Pkwy Ste 5
Flint, MI 48532-3422
Phone (810) 733-8105

Other identifiers 2

IdentifierTypeStateIssuer
1102504361OtherMIBLUE CROSS BLUE SHIELD
4301746MedicaidMI

National Provider Directory

National Provider Directory

Locations

Dept CH 17929
Palatine, IL 60055

3390 N State Rd
Davison, MI 48423
Phone (810) 652-6333

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1851314256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5084 VILLA LINDE PKWY STE 5",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323422",
            "telephone_number": "810-733-8105",
            "fax_number": "810-733-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5084 VILLA LINDE PKWY",
            "address_2": "SUITE 5",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323422",
            "telephone_number": "810-733-8105",
            "fax_number": "810-733-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHMAD AL DABAGH, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "AL DABAGH",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "810-733-8105",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301063880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1102504361",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4301746",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.