Provider Demographics
NPI:1134954753
Name:AL-OBAIDI, ALI
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:AL-OBAIDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17125 W 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2104
Mailing Address - Country:US
Mailing Address - Phone:313-465-2740
Mailing Address - Fax:
Practice Address - Street 1:17125 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2104
Practice Address - Country:US
Practice Address - Phone:313-465-2740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health