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NPI Code Detail

MEDICARE: MRS. MONA WILLIAM ABDELMESEH RPT

MEDICARE: MRS. MONA WILLIAM ABDELMESEH RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501009141MI

General Provider Information

NPI Number : 1073002036
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MONA WILLIAM ABDELMESEH RPT
Provider Business Mailing Address
First Line : 5335 FEDORA DR
Second Line :
City : TROY
State : MI
Zip : 48085-4008
Country : US
Telephone Number : 248-879-2570
Fax Number : 248-879-2570
Provider Business Practice Location Address
First Line : 39312 WOODWARD AVE STE 100
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48304-5007
Country : US
Telephone Number : 248-644-5522
Fax Number : 248-644-0555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2018
Last Update Date : 05/05/2018

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