Healthcare Provider Details

I. General information

NPI: 1013537455
Provider Name (Legal Business Name): LUBNA AYOUBI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E EISENHOWER PKWY STE 200
ANN ARBOR MI
48108-3346
US

IV. Provider business mailing address

19310 OUTER DR
DEARBORN MI
48124-1405
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-7175
  • Fax:
Mailing address:
  • Phone: 313-258-3271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: