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NPI Code Detail

MEDICARE: DR. RANDA AZMEH M.D.

MEDICARE: DR. RANDA AZMEH M.D.
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
1208000000XPediatrics Physician4301067792MI

General Provider Information

NPI Number : 1437343068
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDA AZMEH M.D.
Provider Business Mailing Address
First Line : 6450 MAPLE ST
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2259
Country : US
Telephone Number : 313-216-2202
Fax Number : 313-584-3206
Provider Business Practice Location Address
First Line : 6450 MAPLE ST
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2259
Country : US
Telephone Number : 313-216-2202
Fax Number : 313-584-3206
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2007
Last Update Date : 08/27/2007

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