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General NPI Number Information
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NPI Number | 1760605166
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Entity Type | Individual
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Provider Name | AYAD SHAWKAT JAZRAWI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 710 N CROOKS RD
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City | CLAWSON
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State | MI
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Zip | 48017-1399
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Country | US
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Telephone | 248-288-1117
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Fax | 248-288-1107
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Provider Business Mailing Address
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Address Line | 710 N CROOKS RD
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City | CLAWSON
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State | MI
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Zip | 48017-1399
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Country | US
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Telephone | 248-288-1117
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Fax | 248-288-1107
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301084367
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | 4301084367
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301084367
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 4301084367
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 4301084367
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 4301084367
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301084367
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License Number State | MI
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