Provider Demographics
NPI:1295705531
Name:SLAIM, ABRAHAM (DO)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:SLAIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9340 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3362
Practice Address - Country:US
Practice Address - Phone:313-295-3388
Practice Address - Fax:313-295-4198
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1295705531Medicaid
MIC7890OtherM'CARE
MI700H222490OtherBLUE SHIELD
MI1295705531Medicaid
MIE33176Medicare UPIN