Provider Demographics
NPI:1548237787
Name:ALKIEK, RADWAN (MD)
Entity Type:Individual
Prefix:
First Name:RADWAN
Middle Name:
Last Name:ALKIEK
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 1:160 E WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1092
Mailing Address - Country:US
Mailing Address - Phone:855-466-3621
Mailing Address - Fax:989-466-3643
Practice Address - Street 1:160 E WARWICK DR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1092
Practice Address - Country:US
Practice Address - Phone:855-466-3621
Practice Address - Fax:989-466-3643
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301058502207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0980573OtherHEALTH PLUS OF MICHIGAN
MI3369971Medicaid
MIF10360Medicare UPIN
0M34870010Medicare PIN