MEDICARE: MRS. EAMAN ALHAIDER PA-C

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	363A00000X	Physician Assistant	5601007422	MI

General Provider Information

NPI Number	:	1578948220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EAMAN ALHAIDER PA-C

Provider Business Mailing Address
First Line	:	3053 LINDENWOOD DR
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1311
Country	:	US
Telephone Number	:	313-450-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	3053 LINDENWOOD DR
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1311
Country	:	US
Telephone Number	:	313-450-8998
Fax Number	:

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

Provider Enumeration Date	:	07/23/2015
Last Update Date	:	07/23/2015

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