Provider Demographics
NPI:1326291428
Name:BEYDOUN, RANIA (PA)
Entity Type:Individual
Prefix:MRS
First Name:RANIA
Middle Name:
Last Name:BEYDOUN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30108 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2370
Mailing Address - Country:US
Mailing Address - Phone:734-956-5821
Mailing Address - Fax:734-956-5831
Practice Address - Street 1:30108 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2370
Practice Address - Country:US
Practice Address - Phone:734-956-5821
Practice Address - Fax:734-956-5831
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005435363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant