Healthcare Provider Details

I. General information

NPI: 1730097395
Provider Name (Legal Business Name): MUGEEB AL-HOBISHI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11521 JOSEPH CAMPAU ST
HAMTRAMCK MI
48212-3050
US

IV. Provider business mailing address

11521 JOSEPH CAMPAU ST STE B
HAMTRAMCK MI
48212-3050
US

V. Phone/Fax

Practice location:
  • Phone: 313-733-4256
  • Fax: 313-733-4265
Mailing address:
  • Phone: 313-733-4256
  • Fax: 313-733-4265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: