Healthcare Provider Details

I. General information

NPI: 1548845522
Provider Name (Legal Business Name): MOHAMAD MAZEN ALHAKIM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 S ROCHESTER RD STE 105
ROCHESTER HILLS MI
48307-3151
US

IV. Provider business mailing address

1349 S ROCHESTER RD STE 105
ROCHESTER HILLS MI
48307-3151
US

V. Phone/Fax

Practice location:
  • Phone: 248-652-6336
  • Fax: 586-254-3872
Mailing address:
  • Phone: 248-652-6336
  • Fax: 586-254-3872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMAD ALHAKIM
Title or Position: OWNER
Credential: MD
Phone: 248-652-6336