Provider Demographics
NPI:1326464231
Name:ALJUNDI MEDICAL PLLC
Entity Type:Organization
Organization Name:ALJUNDI MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEND
Authorized Official - Middle Name:
Authorized Official - Last Name:ALJUNDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-635-0367
Mailing Address - Street 1:2001 MAPLERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2750
Mailing Address - Country:US
Mailing Address - Phone:248-635-0367
Mailing Address - Fax:
Practice Address - Street 1:4000 HIGHLAND RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2167
Practice Address - Country:US
Practice Address - Phone:248-635-0367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-16
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059857207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1154314136OtherNPI
MI1109310811OtherBCBSM
MI11270589OtherCAQH
MI1154314136OtherNPI