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General NPI Number Information
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NPI Number | 1144757949
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Entity Type | Individual
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Provider Name | ISRAA ODAY GHANIM AL-GBURI MD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 44405 WOODWARD AVE, H-23 ST. JOSEPH MERCY OAKLAND
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City | PONTIAC
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State | MI
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Zip | 48341
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Country | US
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Telephone | 206-612-6626
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Fax |
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Provider Business Mailing Address
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Address Line | 4045 LINKWOOD DRIVE APT # 724
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City | HOUSTON
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State | TX
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Zip | 77025
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Country | US
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Telephone | 206-612-6626
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01090931A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01090931A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | IN PROCESS
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License Number State | MI
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