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Individual

ISRAA ODAY GHANIM AL-GBURI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
44405 WOODWARD AVE, H-23, ST. JOSEPH MERCY OAKLAND, PONTIAC, MI 48341
(206) 612-6626
Mailing address
4045 LINKWOOD DRIVE, APT # 724, HOUSTON, TX 77025
(206) 612-6626

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01090931A
IN
207R00000X
Internal Medicine Physician
Primary
IN PROCESS
MI
207RC0000X
Cardiovascular Disease Physician
01090931A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1103692588
ANTHEM PTAN
IN
05
300078980
IN
Enumeration date
05/11/2017
Last updated
04/08/2026
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