Provider Demographics
NPI:1053454462
Name:ALNAJJAR PLASTIC AND RECONSTRUCTIVE SURGERY PC
Entity Type:Organization
Organization Name:ALNAJJAR PLASTIC AND RECONSTRUCTIVE SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:ALNAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-930-3941
Mailing Address - Street 1:1313 INDIAN MOUND TRL
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-2275
Mailing Address - Country:US
Mailing Address - Phone:248-930-3941
Mailing Address - Fax:
Practice Address - Street 1:915 E MAPLE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6410
Practice Address - Country:US
Practice Address - Phone:248-971-2121
Practice Address - Fax:248-642-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074508208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty