Healthcare Provider Details

I. General information

NPI: 1235313198
Provider Name (Legal Business Name): HOPE CANCER CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44200 WOODWARD AVENUE SUITE 210
PONTIAC MI
48341
US

IV. Provider business mailing address

44200 WOODWARD AVENUE SUITE 210
PONTIAC MI
48341
US

V. Phone/Fax

Practice location:
  • Phone: 248-335-3930
  • Fax: 248-335-3933
Mailing address:
  • Phone: 248-335-3930
  • Fax: 248-335-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberAO066999
License Number StateMI

VIII. Authorized Official

Name: ALAA OWAINATI
Title or Position: PRESIDENT
Credential: MD
Phone: 248-335-3930