Provider Demographics
NPI:1679688550
Name:GHALIB, MAY (MD)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:
Last Name:GHALIB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 S LINDEN RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3454
Mailing Address - Country:US
Mailing Address - Phone:810-515-1701
Mailing Address - Fax:810-715-9142
Practice Address - Street 1:1128 S LINDEN RD
Practice Address - Street 2:SUITE 11
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3454
Practice Address - Country:US
Practice Address - Phone:810-732-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074635207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1008159OtherMCLAREN HEALTH ADVANTAGE
MI104852994Medicaid
MIMG074635OtherBLUE CROSS BLUE SHIELD