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General NPI Number Information
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NPI Number | 1306853221
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Entity Type | Individual
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Provider Name | MALIK DABABNEH DO
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 11/10/2012
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Provider Practice Location Address
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Address Line | 6050 GREENFIELD RD SUITE 101
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City | DEARBORN
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State | MI
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Zip | 48126-6004
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Country | US
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Telephone | 313-945-9000
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Fax | 313-945-7500
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Provider Business Mailing Address
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Address Line | 6050 GREENFIELD RD SUITE 101
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City | DEARBORN
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State | MI
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Zip | 48126-6004
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Country | US
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Telephone | 313-945-9000
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Fax | 313-945-7500
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-087287
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101009532
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License Number State | MI
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