Provider Demographics
NPI:1790730257
Name:DAGHER, ALI M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:M
Last Name:DAGHER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2012 MONROE ST
Mailing Address - Street 2:STE # 105
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2938
Mailing Address - Country:US
Mailing Address - Phone:313-278-2450
Mailing Address - Fax:313-278-2452
Practice Address - Street 1:2012 MONROE ST
Practice Address - Street 2:STE # 105
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2938
Practice Address - Country:US
Practice Address - Phone:313-278-2450
Practice Address - Fax:313-278-2452
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2013-11-03
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Provider Licenses
StateLicense IDTaxonomies
MI4301066833207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE88927Medicare UPIN