Provider Demographics
NPI:1043417926
Name:ALKATIB, AZIZ (MD)
Entity Type:Individual
Prefix:DR
First Name:AZIZ
Middle Name:
Last Name:ALKATIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WILLIAM CARLS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-2201
Mailing Address - Country:US
Mailing Address - Phone:248-937-4764
Mailing Address - Fax:248-937-4729
Practice Address - Street 1:1 WILLIAM CARLS DR STE 100
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-2201
Practice Address - Country:US
Practice Address - Phone:248-937-4764
Practice Address - Fax:248-937-4729
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103267207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MNP00733651OtherMEDICARE RAILROAD
MNP00733651OtherMEDICARE RAILROAD