Provider Demographics
NPI:1225571417
Name:KARAM, JAWAD ALAM
Entity Type:Individual
Prefix:
First Name:JAWAD
Middle Name:ALAM
Last Name:KARAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32251 GLEN CV
Mailing Address - Street 2:APT 1
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3659
Mailing Address - Country:US
Mailing Address - Phone:248-296-4053
Mailing Address - Fax:
Practice Address - Street 1:17200 E 10 MILE RD
Practice Address - Street 2:STE 165
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3349
Practice Address - Country:US
Practice Address - Phone:586-298-6909
Practice Address - Fax:586-298-6914
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist