Individual
MR. IBRAHIM HUSSEIN DABAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1768 FORD AVE, WYANDOTTE, MI 48192-2306
(313) 377-5758
(734) 574-6060
Mailing address
1768 FORD AVE, WYANDOTTE, MI 48192-2306
(734) 299-0712
(734) 574-6060
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601004858
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1158216100
BCBS
MI
Enumeration date
11/16/2007
Last updated
12/19/2022
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