EXECUTIVE DIAGNOSTIC GROUP, PLLC
NPI 1881955953
Clinic/Center - Multi-Specialty in Dearborn, MI

Active since June 05, 2012
1711 MONROE ST, DEARBORN, MI 48124(313) 359-9361(313) 436-1767 Get Directions Write a Review

NPPES record last updated: September 18, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Executive Diagnostic Group, Pllc NPPES

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

EXECUTIVE DIAGNOSTIC GROUP, PLLC (NPI 1881955953) is a healthcare organization registered as a multi-specialty in Dearborn, Michigan and active in the NPI registry since June 2012. The organization lists Luis C Jorge, Owner, as its authorized official.

NPPES Registry Identity

NPI1881955953
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameEXECUTIVE DIAGNOSTIC GROUP, PLLC
Location Address1711 MONROE STDearborn, MI 48124-2914
Mailing Address1711 Monroe StDearborn, MI 48124-2914 · (313) 359-9361 · Fax (313) 436-1767
Fax(313) 436-1767
Organization SubpartNo
Authorized OfficialLuis C JorgeOwner · (313) 359-9361
Enumeration DateJune 5, 2012
Last NPPES UpdateSeptember 18, 2014
NPI 1881955953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
License Licensed in MI · 4301038699
1711 MONROE ST, Dearborn, MI 48124

Other Providers at the Same Location NPPES 10

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

Internal Medicine
1711 MONROE ST
DEARBORN, MI 48124
Physical Therapist
1711 MONROE ST
DEARBORN, MI 48124
Internal Medicine
1711 MONROE ST
DEARBORN, MI 48124
Internal Medicine
1711 MONROE ST
DEARBORN, MI 48124
Hospice Care, Community Based
1711 MONROE ST
DEARBORN, MI 48124
Internal Medicine
1711 MONROE ST
DEARBORN, MI 48124
Home Health
1711 MONROE ST, SUITE A
DEARBORN, MI 48124
Clinic/Center (Physical Therapy)
1711 MONROE ST
DEARBORN, MI 48124

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Executive Diagnostic Group, PLLC's NPI number?

The NPI number for Executive Diagnostic Group, PLLC is 1881955953. It was assigned to this organization in the NPPES registry on June 5, 2012.

Where is Executive Diagnostic Group, PLLC located?

Executive Diagnostic Group, PLLC is located at 1711 Monroe St, Dearborn, MI 48124. The listed phone number is (313) 359-9361.

What is Executive Diagnostic Group, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Executive Diagnostic Group, PLLC was last updated on September 18, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.