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General NPI Number Information
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NPI Number | 1689294100
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Entity Type | Individual
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Provider Name | BAHAA ALI ELZEIN MD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 23810 MICHIGAN AVE STE 102
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City | DEARBORN
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State | MI
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Zip | 48124-1830
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Country | US
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Telephone | 313-995-1796
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Fax |
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Provider Business Mailing Address
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Address Line | 22737 ARLINGTON ST
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City | DEARBORN
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State | MI
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Zip | 48128-1801
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Country | US
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Telephone | 313-995-1796
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301509202
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036167716
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License Number State | IL
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