Provider Demographics
NPI:1326230038
Name:ALSIBAE, MOHAMAD RASM (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMAD RASM
Middle Name:
Last Name:ALSIBAE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MOHAMAD
Other - Middle Name:RASM
Other - Last Name:ALSIBAE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7241 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3698
Mailing Address - Country:US
Mailing Address - Phone:248-408-4088
Mailing Address - Fax:
Practice Address - Street 1:3535 W 13 MILE RD STE 248
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6770
Practice Address - Country:US
Practice Address - Phone:248-551-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082634207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine