Healthcare Provider Details

I. General information

NPI: 1104042084
Provider Name (Legal Business Name): ZEENA MOHAMMAD AL-RUFAIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4967 CROOKS RD STE 250
TROY MI
48098-5809
US

IV. Provider business mailing address

4967 CROOKS RD STE 250
TROY MI
48098-5809
US

V. Phone/Fax

Practice location:
  • Phone: 248-654-6499
  • Fax: 248-918-2609
Mailing address:
  • Phone: 248-654-6499
  • Fax: 248-918-2609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301095449
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License Number4301095449
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: