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General NPI Number Information
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NPI Number | 1588466536
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Entity Type | Individual
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Provider Name | MHD MANAR AL JAWISH MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 5333 MCAULEY DR RM 4001
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City | YPSILANTI
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State | MI
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Zip | 48197-1099
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Country | US
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Telephone | 734-712-3980
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 SAN PABLO RD S APT 2103
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City | JACKSONVILLE
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State | FL
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Zip | 32224-4829
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Country | US
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Telephone | 904-219-1996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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