Healthcare Provider Details

I. General information

NPI: 1598968547
Provider Name (Legal Business Name): ABDULWAHHAB ALROAINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 N TELEGRAPH RD
MONROE MI
48162-3334
US

IV. Provider business mailing address

465 N TELEGRAPH RD
MONROE MI
48162-3334
US

V. Phone/Fax

Practice location:
  • Phone: 734-242-8880
  • Fax: 734-384-0139
Mailing address:
  • Phone: 734-242-8880
  • Fax: 242-384-0139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301081138
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301081138
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number4301081138
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: