=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467037622
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ULTRACARE OBGYN PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2021
-----------------------------------------------------
Last Update Date | 07/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8191 N WAYNE RD STE 4
-----------------------------------------------------
City | WESTLAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48185-1289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-939-8874
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8191 N WAYNE RD STE 4
-----------------------------------------------------
City | WESTLAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48185-1289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-338-9762
-----------------------------------------------------
Fax | 734-338-6761
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LUNA ALKHAFAJI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 734-338-9762
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------