Healthcare Provider Details

I. General information

NPI: 1447632369
Provider Name (Legal Business Name): MOHAMAD YSER ORABI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2015
Last Update Date: 05/27/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44555 WOODWARD AVE SUITE 104
PONTIAC MI
48341
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR. SUITE J2000
ANN ARBOR MI
48105
US

V. Phone/Fax

Practice location:
  • Phone: 248-858-6104
  • Fax: 734-623-2857
Mailing address:
  • Phone: 734-222-3100
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2019-00871
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301512198
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number036172209
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number2019-00871
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number4301512198
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036172209
License Number StateIL
# 7
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301512198
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: