Provider Demographics
NPI:1568750198
Name:ALRAHOMI, TAHA (MD)
Entity Type:Individual
Prefix:
First Name:TAHA
Middle Name:
Last Name:ALRAHOMI
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 1:29150 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2848
Mailing Address - Country:US
Mailing Address - Phone:734-762-3600
Mailing Address - Fax:734-762-3611
Practice Address - Street 1:29150 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2848
Practice Address - Country:US
Practice Address - Phone:734-762-3600
Practice Address - Fax:734-762-3611
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301099545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine