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NPI Code Detail

MEDICARE: MARIAM ABDALLA

MEDICARE: MARIAM ABDALLA
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
1104100000XSocial Worker6851110735MI

General Provider Information

NPI Number : 1619696051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAM ABDALLA
Provider Business Mailing Address
First Line : 2241 NORMANDY DR
Second Line :
City : TROY
State : MI
Zip : 48085-1077
Country : US
Telephone Number : 313-421-4698
Fax Number :
Provider Business Practice Location Address
First Line : 3601 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5356
Country : US
Telephone Number : 586-722-7253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2022
Last Update Date : 08/26/2022

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Directions to “ MARIAM ABDALLA ” Practice Location

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