Healthcare Provider Details

I. General information

NPI: 1922665314
Provider Name (Legal Business Name): MOHAMAD MAKKI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42855 GARFIELD RD STE 112
CLINTON TOWNSHIP MI
48038-5027
US

IV. Provider business mailing address

6915 OAKMAN BLVD
DEARBORN MI
48126-1894
US

V. Phone/Fax

Practice location:
  • Phone: 586-228-3180
  • Fax:
Mailing address:
  • Phone: 313-384-9197
  • 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: