Provider Demographics
NPI:1881216216
Name:JABER, MOHAMMAD AWAD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:AWAD
Last Name:JABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 ST. ANTOINE, UHC 9C, DETROIT MEDICAL CENTER GME OF
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-745-5146
Mailing Address - Fax:313-966-0880
Practice Address - Street 1:6071 W. OUTER DRIVE, DMC SINAI-GRACE HOSPITAL
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-966-7434
Practice Address - Fax:313-966-1738
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2022-02-11
Deactivation Date:2022-01-11
Deactivation Code:
Reactivation Date:2022-02-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program