Organization Active NPI

Blessings Medical Center PC

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1881752301
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301407507 Issued in MI
Legal business name
BLESSINGS MEDICAL CENTER PC
Practice address
4828 W Warren Ave
Detroit, MI 48210-1470
Phone
(313) 506-5706
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Dr. Waad M Dakkak, M.D.
Title
Owner
Phone
(313) 506-5706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301407507 MI Primary

Addresses

Primary practice location

4828 W Warren Ave
Detroit, MI 48210-1470

Mailing address

4828 W Warren Ave
Detroit, MI 48210-1470
Phone (313) 506-5706

Other identifiers 2

IdentifierTypeStateIssuer
10 4966995MedicaidMI
110H203000OtherMIBCBSM

National Provider Directory

National Provider Directory

Locations

4828 W Warren Ave
Detroit, MI 48210
Phone (313) 836-1699

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1881752301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482101470",
            "telephone_number": "313-506-5706",
            "fax_number": "248-274-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482101470",
            "telephone_number": "313-506-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSINGS MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "DAKKAK",
        "authorized_official_first_name": "WAAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-506-5706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301407507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10 4966995",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "110H203000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.