Provider Demographics
NPI:1568193654
Name:ALNASARAT, AHMAD MOHAMMAD MOUSA (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:MOHAMMAD MOUSA
Last Name:ALNASARAT
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 1:4201 ST. ANTOINE, UHC-9C
Mailing Address - Street 2:UHC-9C DETROIT MEDICAL CENTER, GME OFFICE
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:248-671-7030
Mailing Address - Fax:
Practice Address - Street 1:4201 ST. ANTOINE, UHC-9C
Practice Address - Street 2:DETROIT MEDICAL CENTER, GME OFFICE
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:248-671-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program