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General NPI Number Information
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NPI Number | 1528244647
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Entity Type | Organization
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Legal Business Name | GHALEB F HATEM, MD, PC
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 4655 S TELEGRAPH RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1936
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Country | US
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Telephone | 313-295-2888
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Fax | 313-295-7923
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Provider Business Mailing Address
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Address Line | 4655 S TELEGRAPH RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1936
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Country | US
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Telephone | 313-295-2888
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Fax | 313-295-7923
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Authorized Official
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Title or Position | OWNER
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Name | DR. GHALEB F HATEM
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Credential | M.D.
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Telephone | 313-295-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301040489
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License Number State | MI
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