Provider Demographics
NPI:1073002036
Name:ABDELMESEH, MONA WILLIAM (RPT)
Entity Type:Individual
Prefix:MRS
First Name:MONA
Middle Name:WILLIAM
Last Name:ABDELMESEH
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MRS
Other - First Name:MONA
Other - Middle Name:WILLIAM
Other - Last Name:ABDELMESEH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MONA ABDELMESEH
Mailing Address - Street 1:5335 FEDORA DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-4008
Mailing Address - Country:US
Mailing Address - Phone:248-879-2570
Mailing Address - Fax:248-879-2570
Practice Address - Street 1:39312 WOODWARD AVE STE 100
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5007
Practice Address - Country:US
Practice Address - Phone:248-644-5522
Practice Address - Fax:248-644-0555
Is Sole Proprietor?:No
Enumeration Date:2018-05-05
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist