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General NPI Number Information
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NPI Number | 1376857763
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Entity Type | Organization
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Legal Business Name | WAFIE ROUMAYAH, MD, PC
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 3345 COOLIDGE HWY
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City | BERKLEY
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State | MI
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Zip | 48072-1635
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Country | US
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Telephone | 248-544-7110
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Fax | 248-544-7112
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Provider Business Mailing Address
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Address Line | 3345 COOLIDGE HWY
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City | BERKLEY
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State | MI
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Zip | 48072-1635
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Country | US
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Telephone | 248-544-7110
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Fax | 248-544-7112
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MR. WAFIE DANIAL ROUMAYAH
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Credential | M.D.
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Telephone | 248-544-7110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | WR047991
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License Number State | MI
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