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General NPI Number Information
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NPI Number | 1225367956
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Entity Type | Individual
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Provider Name | MARWAN RABAH AL-HAJEILI M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 22101 MOROSS RD PB 2
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City | DETROIT
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State | MI
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Zip | 48236-2148
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Country | US
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Telephone | 313-343-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 483 ALLARD AVE
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-2811
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Country | US
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Telephone | 312-823-7493
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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 | L1645369
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L1645370
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License Number State | MI
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