Provider Demographics
NPI:1508432683
Name:JAWAD, RASHA
Entity Type:Individual
Prefix:
First Name:RASHA
Middle Name:
Last Name:JAWAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WOODBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2132
Mailing Address - Country:US
Mailing Address - Phone:313-903-0422
Mailing Address - Fax:
Practice Address - Street 1:22255 GREENFIELD RD STE 352
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3712
Practice Address - Country:US
Practice Address - Phone:248-849-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-31
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351051476207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology