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General NPI Number Information
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NPI Number | 1235147133
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Entity Type | Individual
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Provider Name | SAMER A. KAFELGHAZAL MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16322 MIDDLEBELT
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City | LIVONIA
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State | MI
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Zip | 48154
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Country | US
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Telephone | 734-522-8590
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Fax | 734-522-7686
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Provider Business Mailing Address
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Address Line | 30001 HICKORY LANE
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City | FRANKLIN
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State | MI
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Zip | 48025
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Country | US
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Telephone | 248-865-3376
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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 | 4301058710
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License Number State | MI
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