Provider Demographics
NPI:1437686367
Name:HAMADE, ALI (LMT)
Entity Type:Individual
Prefix:MR
First Name:ALI
Middle Name:
Last Name:HAMADE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22030 FORD RD STE B
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2418
Mailing Address - Country:US
Mailing Address - Phone:313-406-2410
Mailing Address - Fax:313-228-5294
Practice Address - Street 1:22030 FORD RD STE B
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2418
Practice Address - Country:US
Practice Address - Phone:313-406-2410
Practice Address - Fax:313-228-5294
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501009840225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist