Provider Demographics
NPI:1336119437
Name:RAZOOK, HADEEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HADEEL
Middle Name:
Last Name:RAZOOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR LBBY J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:248-674-9309
Practice Address - Street 1:4400 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-1222
Practice Address - Country:US
Practice Address - Phone:248-618-6000
Practice Address - Fax:248-618-6951
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHR080419207Q00000X
MI4301080419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F37550OtherBCBSM GROUP
MI1336119437Medicaid
MI1336119437Medicaid