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General NPI Number Information
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NPI Number | 1124237516
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Entity Type | Organization
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Legal Business Name | ALEX BOUHACHEM DPM PC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 10801 W WARREN AVE
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City | DEARBORN
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State | MI
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Zip | 48126-1191
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Country | US
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Telephone | 313-406-4201
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Fax | 313-406-4293
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Provider Business Mailing Address
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Address Line | 1813 N ROSEVERE AVE
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City | DEARBORN
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State | MI
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Zip | 48128-1242
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Country | US
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Telephone | 313-406-4201
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Fax | 313-406-4293
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Authorized Official
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Title or Position | CEO
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Name | ALEX BOUHACHEM
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Credential | DPM
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Telephone | 313-406-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 5901002050
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License Number State | MI
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