Healthcare Provider Details

I. General information

NPI: 1396345666
Provider Name (Legal Business Name): ANHA MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2328 LIVERNOIS RD STE 1060
TROY MI
48083-1656
US

IV. Provider business mailing address

6402 GOLFVIEW ST
GARDEN CITY MI
48135-2005
US

V. Phone/Fax

Practice location:
  • Phone: 313-207-6210
  • Fax:
Mailing address:
  • Phone: 313-207-6210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED MOUSTAFA EL-FAKHARANY
Title or Position: OWNER
Credential: MD
Phone: 313-207-6210