Provider Demographics
NPI:1477631141
Name:ALRAWI, ATHEAR M (MD)
Entity Type:Individual
Prefix:DR
First Name:ATHEAR
Middle Name:M
Last Name:ALRAWI
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 1:811 EAST ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3033
Mailing Address - Country:US
Mailing Address - Phone:810-267-9700
Mailing Address - Fax:810-356-5819
Practice Address - Street 1:811 EAST ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3033
Practice Address - Country:US
Practice Address - Phone:810-267-9700
Practice Address - Fax:810-356-5819
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071008207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11810958OtherCAQH
MI1477631141Medicaid