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General NPI Number Information
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NPI Number | 1932024205
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Entity Type | Individual
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Provider Name | MOHAMED ELAMIN OMER ABDALLA
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Gender | Male
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/22/2026
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Provider Practice Location Address
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Address Line | 4201 SAINT ANTOINE ST # 5C
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-577-5092
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Fax |
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Provider Business Mailing Address
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Address Line | 1760 KIRTS BLVD APT 108
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City | TROY
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State | MI
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Zip | 48084-4342
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Country | US
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Telephone | 720-592-5717
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 4351057182
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License Number State | MI
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