Provider Demographics
NPI:1679223739
Name:ALMUKHTAR, RAAD
Entity Type:Individual
Prefix:
First Name:RAAD
Middle Name:
Last Name:ALMUKHTAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13944 CARDWELL ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-4648
Mailing Address - Country:US
Mailing Address - Phone:734-447-6443
Mailing Address - Fax:
Practice Address - Street 1:19251 MACK AVE STE 340
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2891
Practice Address - Country:US
Practice Address - Phone:313-343-3864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program