Healthcare Provider Details

I. General information

NPI: 1689586406
Provider Name (Legal Business Name): HIBA JOUNI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14716 W WARREN AVE
DEARBORN MI
48126-1347
US

IV. Provider business mailing address

14716 W WARREN AVE
DEARBORN MI
48126-1347
US

V. Phone/Fax

Practice location:
  • Phone: 313-581-9090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: