Individual provider · NPI-1

Ihab Abd Ali, MD

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number1689429417
StatusActive
Last updated in NPPESApr 23, 2024

Details

NPI
1689429417
Entity type
Individual (NPI-1)
Name
Ihab Abd Ali
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 23, 2024
Certification date
Apr 23, 2024
Last updated
Apr 23, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

4201 Saint Antoine St Ste 6a
Detroit, MI 48201-2153

Phone 313-745-4627

Mailing address

4201 Saint Antoine St Ste 9c
Detroit, MI 48201-2153

Phone 313-745-5147

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