PELHAM PRIMARY CARE PC
NPI 1336665728
Internal Medicine in Dearborn, MI

Active since August 17, 2017CLIA 23D2155592 · Waiver
3815 PELHAM ST, DEARBORN, MI 48124(313) 789-7636(313) 789-7018 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Aug 17, 2017 (2 updates tracked since 2017).

About Pelham Primary Care Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PELHAM PRIMARY CARE PC (NPI 1336665728) is a healthcare organization registered as an internal medicine in Dearborn, Michigan and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through October 1, 2026 and lists Ribhi Hazin, Partner, as its authorized official.

NPPES Registry Identity

NPI1336665728
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePELHAM PRIMARY CARE PC
Location Address3815 PELHAM STDearborn, MI 48124-3852
Mailing Address3815 Pelham StDearborn, MI 48124-3852 · (313) 789-7636 · Fax (313) 789-7018
Fax(313) 789-7018
Organization SubpartNo
Authorized OfficialRibhi HazinPartner · (313) 789-7636
Enumeration DateAugust 17, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
NPI 1336665728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

3815 PELHAM ST, Dearborn, MI 48124

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2155592

Pelham Primary Care · Dearborn, MI
Active · expires Oct 1, 2026
CLIA Number23D2155592
Laboratory TypePhysician Office
Certificate Effective DateOctober 2, 2024
Certificate Expiration DateOctober 1, 2026
Laboratory DirectorTalal Khader
Laboratory Phone(313) 789-7635
Laboratory LocationPelham Primary Care3815 Pelham Street Suite 7, Dearborn, MI 48124
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
3815 PELHAM ST, SUITE 11
DEARBORN, MI 48124
Dentist (General Practice)
3815 PELHAM ST, SUITE 11
DEARBORN, MI 48124
Psychiatry & Neurology (Neurology)
3815 PELHAM ST, SUITE 14
DEARBORN, MI 48124
Dentist (General Practice)
3815 PELHAM ST, SUITE 11
DEARBORN, MI 48124
Surgery
3815 PELHAM ST, SUITE 5
DEARBORN, MI 48124
Psychiatry & Neurology (Neuromuscular Medicine)
3815 PELHAM ST
DEARBORN, MI 48124
Pharmacy (Community/Retail Pharmacy)
3815 PELHAM ST, SUITE 3
DEARBORN, MI 48124
Psychiatry & Neurology (Neurology)
3815 PELHAM ST, STE 1
DEARBORN, MI 48124

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336665728, enumerated as an "organization" on August 17, 2017.

The provider is located at 3815 PELHAM ST DEARBORN, MI 48124 and the phone number is (313) 789-7636.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.