Provider Demographics
NPI:1508219163
Name:AL-ANTARY, EMAN TAWFIQ (MD)
Entity Type:Individual
Prefix:
First Name:EMAN
Middle Name:TAWFIQ
Last Name:AL-ANTARY
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:CHILDRENS HOSPITAL OF MICHIGAN 3901 BEAUBIEN BLVD
Mailing Address - Street 2:PEDIATRIC EDUCATION DEPARTMENT
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-745-1892
Mailing Address - Fax:313-993-7118
Practice Address - Street 1:CHILDRENS HOSPITAL OF MICHIGAN 3901 BEAUBIEN BLVD
Practice Address - Street 2:PEDIATRIC EDUCATION DEPARTMENT
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-1892
Practice Address - Fax:313-993-7118
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2022-10-06
Deactivation Date:2017-02-28
Deactivation Code:
Reactivation Date:2017-03-13
Provider Licenses
StateLicense IDTaxonomies
MI4301117041208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics