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General NPI Number Information
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NPI Number | 1790797355
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Entity Type | Individual
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Provider Name | BISHR ABDASSALAM AL-UJAYLI M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 1349 S. ROCHESTER ROAD SUITE 115
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-3817
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Country | US
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Telephone | 248-759-4852
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Fax | 248-299-9860
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Provider Business Mailing Address
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Address Line | 1349 S ROCHESTER RD SUITE 115
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-3150
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Country | US
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Telephone | 248-759-4852
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Fax | 248-299-9860
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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 | 4301054466
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4301054466
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License Number State | MI
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