Provider Demographics
NPI:1578948220
Name:ALHAIDER, EAMAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:EAMAN
Middle Name:
Last Name:ALHAIDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 LINDENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1311
Mailing Address - Country:US
Mailing Address - Phone:313-450-8998
Mailing Address - Fax:
Practice Address - Street 1:3053 LINDENWOOD DR
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1311
Practice Address - Country:US
Practice Address - Phone:313-450-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007422363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant