Healthcare Provider Details
I. General information
NPI: 1932300290
Provider Name (Legal Business Name): ZAID AL-WAHAB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/31/2007
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16815 E JEFFERSON AVE STE 240
GROSSE POINTE MI
48230-1923
US
IV. Provider business mailing address
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US
V. Phone/Fax
- Phone: 313-473-4690
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VH0002X |
| Taxonomy | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician |
| License Number | 4301086657 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 4301086657 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 4301086657 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: