Healthcare Provider Details

I. General information

NPI: 1316163199
Provider Name (Legal Business Name): AHMAD M. SAMHOURI M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44038 WOODWARD AVE SUITE 101
BLOOMFIELD HILLS MI
48302-5035
US

IV. Provider business mailing address

44038 WOODWARD AVE SUITE 101
BLOOMFIELD HILLS MI
48302-5035
US

V. Phone/Fax

Practice location:
  • Phone: 248-334-0050
  • Fax: 248-334-1368
Mailing address:
  • Phone: 248-334-0050
  • Fax: 248-334-1368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number4301034418
License Number StateMI

VIII. Authorized Official

Name: DR. AHMAD M. SAMHOURI
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 248-334-0050