Provider Demographics
NPI:1073829149
Name:MOHAMMED ALOGAILY M.D. P.C.
Entity Type:Organization
Organization Name:MOHAMMED ALOGAILY M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING/REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NOTORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-710-0907
Mailing Address - Street 1:16305 ASPEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4432
Mailing Address - Country:US
Mailing Address - Phone:248-924-3312
Mailing Address - Fax:734-365-5106
Practice Address - Street 1:21100 ALLEN RD
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-1694
Practice Address - Country:US
Practice Address - Phone:734-365-5154
Practice Address - Fax:734-365-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062279174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty