Healthcare Provider Details

I. General information

NPI: 1912338187
Provider Name (Legal Business Name): RADWA EMAD HOZAIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RADWA HASSAN

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. JOHN HOSPITAL & MEDICAL CENTER 22101 MOROSS
DETROIT MI
48236
US

IV. Provider business mailing address

47542 WOODBERRY ESTATES DR
MACOMB MI
48044-3044
US

V. Phone/Fax

Practice location:
  • Phone: 313-343-4370
  • Fax:
Mailing address:
  • Phone: 313-706-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704267468
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: