Individual provider · NPI-1

Abdulkader Al-Azzaz, MD

· Southfield, MI

NPI number1801079751
StatusActive
Last updated in NPPESSep 12, 2025

Details

NPI
1801079751
Entity type
Individual (NPI-1)
Name
Abdulkader Al-Azzaz
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Dec 14, 2007
Certification date
Sep 12, 2025
Last updated
Sep 12, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085N0700X 4301068399MIYes

Practice location

24500 Northwestern Hwy
Suite 100
Southfield, MI 48075-2414

Phone 248-353-1280 · Fax 248-353-6193

Mailing address

24500 Northwestern Hwy
Suite 100
Southfield, MI 48075-2414

Phone 248-353-1280 · Fax 248-353-6193

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