Healthcare Provider Details

I. General information

NPI: 1386565422
Provider Name (Legal Business Name): MRS. RUKAYA HASAN ALSHATRI I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6425 SCHAEFER RD
DEARBORN MI
48126-1974
US

IV. Provider business mailing address

6905 SAINT MARYS ST APT 2
DETROIT MI
48228-5229
US

V. Phone/Fax

Practice location:
  • Phone: 313-552-6670
  • Fax:
Mailing address:
  • Phone: 313-552-6670
  • Fax: 313-552-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: