Healthcare Provider Details

I. General information

NPI: 1306837018
Provider Name (Legal Business Name): MOHAMAD MAZEN ALHAKIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 W 13 MILE RD STE 240
ROYAL OAK MI
48073-6710
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 248-551-5566
  • Fax: 248-551-4761
Mailing address:
  • Phone: 844-832-1956
  • Fax: 989-633-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301051342
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: