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General NPI Number Information
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NPI Number | 1942756234
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Entity Type | Individual
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Provider Name | AHMED ALRAJJAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 459 CALVIN AVENUE
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-3236
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Country | US
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Telephone | 832-866-8463
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Fax | 313-343-8318
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Provider Business Mailing Address
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Address Line | 459 CALVIN AVE
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-3236
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Country | US
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Telephone | 832-866-8463
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Fax | 313-343-8318
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 4301107920
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 4301116935
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License Number State | MI
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