Healthcare Provider Details

I. General information

NPI: 1336119437
Provider Name (Legal Business Name): HADEEL RAZOOK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 HIGHLAND RD
WATERFORD MI
48328-1222
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR LBBY J2000
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 248-618-6000
  • Fax: 248-618-6951
Mailing address:
  • Phone: 734-747-6766
  • Fax: 248-674-9309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberHR080419
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301080419
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: