Provider Demographics
NPI:1821339797
Name:DEEN, MOSAB RAMZI MUHI (DO)
Entity Type:Individual
Prefix:DR
First Name:MOSAB
Middle Name:RAMZI MUHI
Last Name:DEEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:MUSSOP
Other - Middle Name:RAMZI
Other - Last Name:MOHAMMAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:601 E MAIN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-7460
Mailing Address - Country:US
Mailing Address - Phone:248-404-0501
Mailing Address - Fax:313-261-0322
Practice Address - Street 1:41000 WOODWARD AVE STE 350
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5092
Practice Address - Country:US
Practice Address - Phone:248-561-0602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020789207LP2900X, 207R00000X, 208D00000X
NY301155-01207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine