Healthcare Provider Details

I. General information

NPI: 1114532330
Provider Name (Legal Business Name): RULA AL-AOUAR PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23801 W WARREN ST STE 103
DEARBORN HEIGHTS MI
48127-2277
US

IV. Provider business mailing address

23801 W WARREN ST STE 3
DEARBORN HEIGHTS MI
48127-2276
US

V. Phone/Fax

Practice location:
  • Phone: 313-410-2269
  • Fax:
Mailing address:
  • Phone: 313-633-9509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: RULA N AL-AOUAR
Title or Position: MD
Credential: MD
Phone: 313-633-9509