Healthcare Provider Details

I. General information

NPI: 1013412923
Provider Name (Legal Business Name): RONNY HADID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2018
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18181 OAKWOOD BLVD STE 208
DEARBORN MI
48124-5031
US

IV. Provider business mailing address

4360 PONTIAC TRL
ORCHARD LAKE MI
48323-1665
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-5565
  • Fax: 313-271-1053
Mailing address:
  • Phone: 248-421-0117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4301503441
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number4301503441
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4301503441
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: