Healthcare Provider Details

I. General information

NPI: 1790489532
Provider Name (Legal Business Name): BILAL AL SIBAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

IV. Provider business mailing address

22201 MOROSS RD STE 50
DETROIT MI
48236-2166
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-7400
  • Fax:
Mailing address:
  • Phone: 313-343-7774
  • Fax: 313-343-8747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.156009
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.156009
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: