Healthcare Provider Details

I. General information

NPI: 1689406134
Provider Name (Legal Business Name): NADAA ALI ALHACHAMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 S GULLEY RD
DEARBORN MI
48124-4405
US

IV. Provider business mailing address

3231 S GULLEY RD
DEARBORN MI
48124-4405
US

V. Phone/Fax

Practice location:
  • Phone: 313-278-2327
  • Fax:
Mailing address:
  • Phone: 313-278-2327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: