Healthcare Provider Details

I. General information

NPI: 1831013598
Provider Name (Legal Business Name): HASSAN JABER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5502 MIDDLESEX ST
DEARBORN MI
48126-5020
US

IV. Provider business mailing address

5502 MIDDLESEX ST
DEARBORN MI
48126-5020
US

V. Phone/Fax

Practice location:
  • Phone: 313-587-6845
  • Fax:
Mailing address:
  • Phone: 313-587-6845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704385760
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: