Healthcare Provider Details

I. General information

NPI: 1134357189
Provider Name (Legal Business Name): MELHEM H HARP D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22150 GREENFIELD RD 203B
OAK PARK MI
48237-2535
US

IV. Provider business mailing address

22150 GREENFIELD RD 203B
OAK PARK MI
48237-2535
US

V. Phone/Fax

Practice location:
  • Phone: 248-246-0533
  • Fax:
Mailing address:
  • Phone: 248-246-5788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101018367
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number036144389
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: