Provider Demographics
NPI:1205853215
Name:HMOUD, JAREER S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAREER
Middle Name:S
Last Name:HMOUD
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 1:13430 E 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-3187
Mailing Address - Country:US
Mailing Address - Phone:248-854-8999
Mailing Address - Fax:248-429-1506
Practice Address - Street 1:13430 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3187
Practice Address - Country:US
Practice Address - Phone:248-854-8999
Practice Address - Fax:248-429-1506
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078586174400000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI105199413Medicaid
MIH98526Medicare UPIN
MI105199413Medicaid
MIP45840001Medicare PIN