Provider Demographics
NPI:1467616904
Name:AL-KHOURI, RAAD RAZOUKI (MD)
Entity Type:Individual
Prefix:
First Name:RAAD
Middle Name:RAZOUKI
Last Name:AL-KHOURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4091 CHATWAL CT
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-0001
Mailing Address - Country:US
Mailing Address - Phone:248-854-4206
Mailing Address - Fax:
Practice Address - Street 1:2107 E 14 MILE RD STE 130
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5970
Practice Address - Country:US
Practice Address - Phone:586-272-2005
Practice Address - Fax:586-272-2006
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine