Healthcare Provider Details

I. General information

NPI: 1760305130
Provider Name (Legal Business Name): MARAM ALOSFUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23500 PARK ST
DEARBORN MI
48124-2598
US

IV. Provider business mailing address

23500 PARK ST
DEARBORN MI
48124-2598
US

V. Phone/Fax

Practice location:
  • Phone: 313-694-7700
  • Fax:
Mailing address:
  • Phone: 313-694-7700
  • Fax: 313-908-6878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: