Provider Demographics
NPI:1255314779
Name:EL-HORR, HICHAM ABDULKARIM (MD)
Entity Type:Individual
Prefix:DR
First Name:HICHAM
Middle Name:ABDULKARIM
Last Name:EL-HORR
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:PO BOX 3087
Mailing Address - Street 2:
Mailing Address - City:MELVINDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48122-0087
Mailing Address - Country:US
Mailing Address - Phone:313-624-3011
Mailing Address - Fax:313-846-3901
Practice Address - Street 1:5728 SCHAEFER RD
Practice Address - Street 2:SUITE 204
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2298
Practice Address - Country:US
Practice Address - Phone:313-624-3011
Practice Address - Fax:313-846-3901
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080756207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4943121Medicaid
MIP00738803OtherRAILROAD MEDICARE
MI0808249182OtherBCBS BCN
MI0P40280005Medicare PIN
MIP00738803OtherRAILROAD MEDICARE
MI4943121Medicaid
MII52527Medicare UPIN