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 is a General Practice Physician 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
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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