MEDICARE: DR. MOHAMMAD ALKHOUJAH MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program	4351046268	MI

General Provider Information

NPI Number	:	1235740820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD ALKHOUJAH MD

Provider Business Mailing Address
First Line	:	2799 W GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-2608
Country	:	US
Telephone Number	:	313-916-7205
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2608
Country	:	US
Telephone Number	:	800-223-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2020
Last Update Date	:	06/17/2024

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