Provider Demographics
NPI:1174690549
Name:HAJJAR-NOLAN, LEILA RAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:LEILA
Middle Name:RAJA
Last Name:HAJJAR-NOLAN
Suffix:
Gender:F
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:HENRY FORD HEALTH SYSTEM
Mailing Address - Street 2:5500 AUTO CLUB DRIVE
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126
Mailing Address - Country:US
Mailing Address - Phone:313-425-4567
Mailing Address - Fax:
Practice Address - Street 1:HENRY FORD HEALTH SYSTEM
Practice Address - Street 2:19401 HUBBARD DRIVE
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126
Practice Address - Country:US
Practice Address - Phone:313-982-8330
Practice Address - Fax:313-982-8294
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI052752207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI289184010Medicaid
LH052752OtherCHAMPUS-CHAMPUS
700H262210OtherBLUE CROSS-BLUE CROSS
LH052752OtherCOMMERCIAL-COMMERCIAL NUMBER
700H262210OtherBLUE CROSS-BLUE CROSS
LH052752OtherCOMMERCIAL-COMMERCIAL NUMBER