Healthcare Provider Details

I. General information

NPI: 1699429175
Provider Name (Legal Business Name): EMAN HIJAB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 COOLIDGE RD STE 200
EAST LANSING MI
48823-6381
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 517-203-3000
  • Fax: 517-203-3003
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301517525
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: