=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659267441
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALBARAA BELAL MUSTAFA ABU ATA M.B.B.S.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2025
-----------------------------------------------------
Last Update Date | 11/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | COREWELL HEALTH WILLIAM BEAUMONT UNIVERSITY HOSPITAL 3535 W 13 MILE RD
-----------------------------------------------------
City | ROYAL OAK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-551-3000
-----------------------------------------------------
Fax | 248-551-2032
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | COREWELL HEALTH WILLIAM BEAUMONT UNIVERSITY HOSPITAL 3535 W 13 MILE RD
-----------------------------------------------------
City | ROYAL OAK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-551-3000
-----------------------------------------------------
Fax | 248-551-2032
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | 4351054814
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------