Provider Demographics
NPI:1205807260
Name:DEEBAJAH, IHAB MOHAMMED (MD)
Entity type:Individual
Prefix:DR
First Name:IHAB
Middle Name:MOHAMMED
Last Name:DEEBAJAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1110 N TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1203
Mailing Address - Country:US
Mailing Address - Phone:313-294-5400
Mailing Address - Fax:313-294-5401
Practice Address - Street 1:6255 INKSTER RD
Practice Address - Street 2:SUITE 204
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2577
Practice Address - Country:US
Practice Address - Phone:734-524-0950
Practice Address - Fax:734-524-0951
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301067420207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1106355991OtherBCBS
MI1109500421OtherBCN
MI1109501061OtherBCN
MIOF51015OtherBLUE CROSS GROUP
MI1106355991OtherBCN
MI1205807260Medicaid
MI1109501061OtherBCBS
MI4597407Medicaid
MI0994971OtherHEALTH PLUS
0995040OtherHEALTH PLUS
MI1109500421OtherBCBS
MI290F34972OtherBLUE CROSS COMMON PROVIDE
MI994970OtherHEALTH PLUS
MIP00643668OtherRAILROAD MEDICARE
0995040OtherHEALTH PLUS
MI1109500421OtherBCBS
MI1106355991OtherBCN
MIP61650001Medicare PIN
MI1109501061OtherBCBS