Healthcare Provider Details

I. General information

NPI: 1376451948
Provider Name (Legal Business Name): TAREQ ALMAWERI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10415 DIX FL 2
DEARBORN MI
48120-1505
US

IV. Provider business mailing address

10415 DIX FL 2
DEARBORN MI
48120-1505
US

V. Phone/Fax

Practice location:
  • Phone: 313-842-8402
  • Fax: 313-842-3135
Mailing address:
  • Phone: 313-603-0302
  • Fax: 313-733-4265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: