Healthcare Provider Details

I. General information

NPI: 1255667416
Provider Name (Legal Business Name): ABDEL KARIM NAWFAL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2009
Last Update Date: 10/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

IV. Provider business mailing address

1350 W BETHUNE ST APT 1807
DETROIT MI
48202-2666
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-1023
  • Fax:
Mailing address:
  • Phone: 313-673-4757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301095267
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: