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General NPI Number Information
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NPI Number | 1265224117
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Entity Type | Individual
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Provider Name | RADWAN AL-DAHHAN
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Gender |
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 21600 NOVI RD STE 400
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City | NOVI
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State | MI
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Zip | 48375-5605
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Country | US
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Telephone | 248-301-0843
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Fax |
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Provider Business Mailing Address
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Address Line | 6620 APPOLINE ST
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City | DEARBORN
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State | MI
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Zip | 48126-1960
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501303828
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License Number State | MI
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