Provider Demographics
NPI:1780242545
Name:BEYDOUN, ALHAN (DO)
Entity type:Individual
Prefix:DR
First Name:ALHAN
Middle Name:
Last Name:BEYDOUN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43347 RIVERBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-4722
Mailing Address - Country:US
Mailing Address - Phone:313-675-9516
Mailing Address - Fax:
Practice Address - Street 1:43347 RIVERBRIDGE CT
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-4722
Practice Address - Country:US
Practice Address - Phone:313-675-9516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026776207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine