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General NPI Number Information
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NPI Number | 1083826473
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Entity Type | Individual
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Provider Name | HAMAD IBRAHIM HAMAD DPT
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Gender | Male
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Dates
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Enumeration Date | 05/06/2007
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Last Update Date | 09/12/2021
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Provider Practice Location Address
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Address Line | 21331 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-3265
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Country | US
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Telephone | 248-376-5834
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Fax |
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Provider Business Mailing Address
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Address Line | 27112 WINSLOW AVE
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City | WARREN
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State | MI
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Zip | 48092-3999
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Country | US
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Telephone | 248-376-5834
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Fax | 586-751-1222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501006920
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License Number State | MI
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