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General NPI Number Information
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NPI Number | 1922249598
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Entity Type | Organization
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Legal Business Name | DETRIOT MEDICAL CENTER
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 03/13/2009
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Provider Practice Location Address
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Address Line | 4646 JOHN R ROAD
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City | DETROIT
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State | MI
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Zip | 48201-1331
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Country | US
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Telephone | 313-721-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 80 E HANCOCK ST APT 711
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City | DETROIT
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State | MI
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Zip | 48201-1331
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Country | US
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Telephone | 313-721-1130
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | DR. RAGHAD MUHSIN ABDUL-KARIM
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Credential | M.D
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Telephone | 313-721-1130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4301090446
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License Number State | MI
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