Provider Demographics
NPI:1003392473
Name:ABD ALGAYOUM, RANDA TAJALDEEN ALSAYED (MD)
Entity Type:Individual
Prefix:
First Name:RANDA
Middle Name:TAJALDEEN ALSAYED
Last Name:ABD ALGAYOUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1400 STACY DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-1449
Mailing Address - Country:US
Mailing Address - Phone:734-773-2624
Mailing Address - Fax:
Practice Address - Street 1:19141 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-6007
Practice Address - Country:US
Practice Address - Phone:313-960-6605
Practice Address - Fax:313-367-2818
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301510275207R00000X, 207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program