Provider Demographics
NPI:1114954039
Name:HOURANI, MAKHOUL R (MD)
Entity Type:Individual
Prefix:DR
First Name:MAKHOUL
Middle Name:R
Last Name:HOURANI
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 1:405 W GREENLAWN
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910
Mailing Address - Country:US
Mailing Address - Phone:517-485-8217
Mailing Address - Fax:517-485-3871
Practice Address - Street 1:405 W GREENLAWN
Practice Address - Street 2:SUITE 230
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910
Practice Address - Country:US
Practice Address - Phone:517-485-8217
Practice Address - Fax:517-485-3871
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMH042073207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P58412OtherBCN
MI0330049OtherBCBS
MI2113433Medicaid
B45870Medicare UPIN
MI2113433Medicaid