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Individual

DR. HADI ALI DOURRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
27144 JOY RD, REDFORD, MI 48239-2368
(313) 937-1400
(313) 937-1402
Mailing address
27144 JOY RD, REDFORD, MI 48239-2368
(313) 937-1400
(313) 937-1402

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301084360
MI
208M00000X
Hospitalist Physician
4301084360
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003975517
NPI #
MI
01
4301084360
STATE LICENSE
MI
05
5177514-10
MI
01
70-0-F32947-0
BCBS CPIN #
MI
Enumeration date
12/08/2006
Last updated
10/28/2019
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