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General NPI Number Information
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NPI Number | 1184813941
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Entity Type | Organization
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Legal Business Name | M. HAITHAM AL-MIDANI, MD PC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 4050 WALLI STRASSE DR
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City | BURTON
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State | MI
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Zip | 48509-1727
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Country | US
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Telephone | 810-743-0680
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 WALLI STRASSE DR
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City | BURTON
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State | MI
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Zip | 48509-1727
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Country | US
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Telephone | 810-743-0680
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. MUHAMMAD HAITHAM AL-MIDANI
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Credential | M.D.
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Telephone | 810-743-0680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301037021
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License Number State | MI
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