Provider Demographics
NPI:1225650567
Name:GHAZI, HANIA (DO)
Entity Type:Individual
Prefix:
First Name:HANIA
Middle Name:
Last Name:GHAZI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5537 SILVER POND
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2059
Mailing Address - Country:US
Mailing Address - Phone:248-631-8319
Mailing Address - Fax:
Practice Address - Street 1:33110 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3307
Practice Address - Country:US
Practice Address - Phone:248-489-9070
Practice Address - Fax:248-489-9076
Is Sole Proprietor?:No
Enumeration Date:2020-05-09
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine