Healthcare Provider Details

I. General information

NPI: 1518821685
Provider Name (Legal Business Name): NADA KOURDI AMMOUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5167 PATRICK RD
WEST BLOOMFIELD MI
48322-1548
US

IV. Provider business mailing address

5167 PATRICK RD
WEST BLOOMFIELD MI
48322-1548
US

V. Phone/Fax

Practice location:
  • Phone: 248-252-2576
  • Fax:
Mailing address:
  • Phone: 248-252-2576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License NumberNA
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: