Healthcare Provider Details

I. General information

NPI: 1497344048
Provider Name (Legal Business Name): OLIVIA ALNAJJAR PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2021
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 MAIN ST
BELLEVILLE MI
48111-3284
US

IV. Provider business mailing address

9178 HIGHLAND RD.
WHITE LAKE MI
48386
US

V. Phone/Fax

Practice location:
  • Phone: 248-266-6073
  • Fax:
Mailing address:
  • Phone: 248-698-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: