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General NPI Number Information
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NPI Number | 1457727307
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Entity Type | Organization
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Legal Business Name | RIBHI HAZIN MD PC
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 4777 E OUTER DR STE 1147
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City | DETROIT
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State | MI
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Zip | 48234-3241
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Country | US
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Telephone | 734-699-2900
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Fax | 313-731-0213
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Provider Business Mailing Address
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Address Line | PO BOX 393
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-0393
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Country | US
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Telephone | 734-699-2900
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Fax | 313-731-0213
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Authorized Official
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Title or Position | OWNER PROVIDER
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Name | RIBHI HAZIN
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Credential | MD
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Telephone | 734-699-2900
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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 | 4301097437
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License Number State | MI
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