Healthcare Provider Details

I. General information

NPI: 1588580559
Provider Name (Legal Business Name): ABDULRAHIM ALSUBEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29732 WOODWARD AVE
ROYAL OAK MI
48073-0906
US

IV. Provider business mailing address

4550 RIVER TRL
BLOOMFIELD HILLS MI
48301-3641
US

V. Phone/Fax

Practice location:
  • Phone: 248-353-1234
  • Fax:
Mailing address:
  • Phone: 248-516-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304447
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: