Provider Demographics
NPI:1922661297
Name:ALSALAHI, AMMAR HASSEN (MD)
Entity Type:Individual
Prefix:MR
First Name:AMMAR
Middle Name:HASSEN
Last Name:ALSALAHI
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 1:22250 PROVIDENCE DR
Mailing Address - Street 2:SUITE #601
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4814
Mailing Address - Country:US
Mailing Address - Phone:248-569-4539
Mailing Address - Fax:248-569-4539
Practice Address - Street 1:22250 PROVIDENCE DR
Practice Address - Street 2:SUITE #601
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4814
Practice Address - Country:US
Practice Address - Phone:248-569-4539
Practice Address - Fax:248-569-4539
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program