Provider Demographics
NPI:1073201042
Name:ALKOOHEJI, ISHAQ MAHMOOD HASHEM AHMED (MBBS)
Entity Type:Individual
Prefix:
First Name:ISHAQ
Middle Name:MAHMOOD HASHEM AHMED
Last Name:ALKOOHEJI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 W BETHUNE ST APT 1904
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2667
Mailing Address - Country:US
Mailing Address - Phone:440-506-5100
Mailing Address - Fax:
Practice Address - Street 1:3901 BEAUBIEN ST RM 3T72
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2196
Practice Address - Country:US
Practice Address - Phone:313-745-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program