Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Executive Plaza Medical, PC

Organization General Practice Physician · NPI 1952715153

Executive Plaza Medical, PC provides General Practice Physician services in Dearborn, Michigan. Licensed in Michigan. Registered with an NPI since 2014.

Licensed in
MI
In the registry since
2014
Specialties on file
4
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

17000 Executive Plaza Dr Ste 103
Dearborn, MI 48126-2793 Not confirmed with CMS for 11 years — call before visiting
Phone: (313) 915-4632
Fax: (313) 915-4634
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X · Licence 5101006652 (MI)
General Practice Physician Taxonomy 208D00000X · Licence 5101006652 (MI)
Multi-Specialty Clinic/Center Taxonomy 261QM1300X · Licence 4301405559 (MI)
Multi-Specialty Clinic/Center Taxonomy 261QM1300X · Licence 4301405324 (MI)

Record details

NPI number1952715153
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hossam Hossein — Manager · (313) 915-4632
NPI enumeratedJune 16, 2014
Last updated in NPPESJanuary 13, 2015
Mailing address17000 Executive Plaza Dr, Suite 103, Dearborn, MI 48126-2793

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