MEDICARE: ABDL-RAWF AL-NOWAYLATI 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
1	2086S0122X	Plastic and Reconstructive Surgery Physician	W2477	TX
2	2086S0122X	Plastic and Reconstructive Surgery Physician	92452	GA
3	2086S0122X	Plastic and Reconstructive Surgery Physician	4301504883	MI

General Provider Information

NPI Number	:	1770921983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDL-RAWF AL-NOWAYLATI M.D.

Provider Business Mailing Address
First Line	:	1500 E. MEDICAL CENTER DR.
Second Line	:	2130 TAUBMAN CENTER, SPC 5340
City	:	ANN ARBOR
State	:	MI
Zip	:	48109
Country	:	US
Telephone Number	:	734-232-4598
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 PEACHTREE ST NE FL MOT9
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-2247
Country	:	US
Telephone Number	:	404-686-4411
Fax Number	:

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

Provider Enumeration Date	:	06/10/2013
Last Update Date	:	01/15/2026

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