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General NPI Number Information
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NPI Number | 1972592582
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Entity Type | Individual
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Provider Name | MUNTHER K ALAIWAT M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 15675 NORTHLINE RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2334
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Country | US
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Telephone | 734-282-3600
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Fax | 734-282-3603
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Provider Business Mailing Address
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Address Line | 1640 FORT ST SUITE D ATTN DENISE
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City | TRENTON
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State | MI
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Zip | 48183-2040
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Country | US
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Telephone | 734-391-3057
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Fax | 734-391-3052
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301069255
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License Number State | MI
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