Healthcare Provider Details

I. General information

NPI: 1548052012
Provider Name (Legal Business Name): BATOOL RADI ABDEL RAHMAN ALWAQFI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 JOHN R ST
DETROIT MI
48201
US

IV. Provider business mailing address

AL'AREQ ST, AL AMERIYA, AL JIMI BUILDING 56, FLAT 6
AL AIN ABU DHABI
20003
AE

V. Phone/Fax

Practice location:
  • Phone: 313-577-0714
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: