Provider Demographics
NPI:1043345374
Name:FIRST CHOICE MEDICAL CENTER P C
Entity type:Organization
Organization Name:FIRST CHOICE MEDICAL CENTER P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADIB
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:ABDOLKARIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-729-1800
Mailing Address - Street 1:33000 PALMER ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186
Mailing Address - Country:US
Mailing Address - Phone:734-729-1800
Mailing Address - Fax:734-729-8030
Practice Address - Street 1:33000 PALMER ROAD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186
Practice Address - Country:US
Practice Address - Phone:734-729-1800
Practice Address - Fax:734-729-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059759207Q00000X
MIAA059759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI417413310Medicaid
MI4174133TYPE10Medicaid
G73908Medicare UPIN
MIG73908Medicare UPIN
MI0P30970Medicare UPIN
MI4174133TYPE10Medicaid