Healthcare Provider Details

I. General information

NPI: 1447859863
Provider Name (Legal Business Name): DR. HOSSAM HOJEIJ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19851 W WARREN AVE
DETROIT MI
48228-3247
US

IV. Provider business mailing address

6537 ORCHARD AVE
DEARBORN MI
48126-1704
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-4050
  • Fax:
Mailing address:
  • Phone: 313-658-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302412710
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: