Provider Demographics
NPI:1194892612
Name:CARE PEDIATRICS PLLC
Entity type:Organization
Organization Name:CARE PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSABBAGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-274-6666
Mailing Address - Street 1:1022 N TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1622
Mailing Address - Country:US
Mailing Address - Phone:313-274-6666
Mailing Address - Fax:313-274-4466
Practice Address - Street 1:1000 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1622
Practice Address - Country:US
Practice Address - Phone:313-274-6666
Practice Address - Fax:313-274-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080518208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI786-1OtherTHC
MI1427056068OtherPHCS
MI151159OtherGREAT LAKES
MI8206102OtherBCN
MI3508206102OtherBCBS GROUP PIN
MI489769110Medicaid
MI6U4930OtherCIGNA
MI12965OtherCAPE MEDICAL
MI6U4930OtherHAP
MI2409638OtherOHS CARE NGS PED
MI6U4930Medicare UPIN