Provider Demographics
NPI:1912914227
Name:HENEIN, VIOLETTE FAWZY (MD)
Entity Type:Individual
Prefix:DR
First Name:VIOLETTE
Middle Name:FAWZY
Last Name:HENEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39621 GARFIELD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038
Mailing Address - Country:US
Mailing Address - Phone:586-226-5555
Mailing Address - Fax:586-226-4441
Practice Address - Street 1:39621 GARFIELD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-226-5555
Practice Address - Fax:586-226-4441
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075343207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1105016401OtherBLUE CROSS BLUE SHIELD
MI4749287-10Medicaid
MI0P19020Medicare PIN
MIG75731Medicare UPIN