Provider Demographics
NPI:1679197305
Name:ABDELHALIM, MOHAMMED ALI (MBCHB)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:ALI
Last Name:ABDELHALIM
Suffix:
Gender:M
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 W 13 MILE RD OFC
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6712
Mailing Address - Country:US
Mailing Address - Phone:248-551-0570
Mailing Address - Fax:248-551-3838
Practice Address - Street 1:3601 W 13 MILE RD OFC
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-551-0570
Practice Address - Fax:248-551-3838
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-28
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351046250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine