Healthcare Provider Details

I. General information

NPI: 1447210026
Provider Name (Legal Business Name): HOUDA H. DAGHER-RODGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 MONROE ST
DEARBORN MI
48124-3491
US

IV. Provider business mailing address

26227 LAWRENCE DR
DEARBORN HEIGHTS MI
48127-3345
US

V. Phone/Fax

Practice location:
  • Phone: 313-730-0070
  • Fax: 313-730-1672
Mailing address:
  • Phone: 313-792-8717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number43010808841
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: