Healthcare Provider Details

I. General information

NPI: 1265344626
Provider Name (Legal Business Name): AHMAD ALHELLU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 GOLFSIDE RD STE 10
YPSILANTI MI
48197-1145
US

IV. Provider business mailing address

2111 GOLFSIDE RD STE 10
YPSILANTI MI
48197-1145
US

V. Phone/Fax

Practice location:
  • Phone: 734-796-7788
  • Fax:
Mailing address:
  • Phone: 734-796-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: