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General NPI Number Information
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NPI Number | 1417231317
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Entity Type | Organization
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Legal Business Name | FOUAD A. DAKHLALLAH,M.D.,P.C.
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 6221 UNIVERSITY DR
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2587
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Country | US
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Telephone | 313-969-0278
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Fax | 313-581-8383
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Provider Business Mailing Address
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Address Line | 340 NORBORNE AVE
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-3758
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Country | US
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Telephone | 313-562-6000
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Fax | 313-562-6002
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Authorized Official
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Title or Position | OWNER
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Name | FOUAD A DAKHLALLAH
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Credential | M.D.
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Telephone | 313-969-0278
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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 | 4301085126
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License Number State | MI
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