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General NPI Number Information
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NPI Number | 1295787687
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Entity Type | Individual
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Provider Name | MOWAFAK ASBAHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 18320 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3230
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Country | US
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Telephone | 248-476-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 43261 WATERWHEEL COURT
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City | NORTHVILLE
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State | MI
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Zip | 48167
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Country | US
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Telephone | 248-349-7122
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MA033455
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License Number State | MI
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