Individual
DR. MOHAMAD AL-JARRAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15830 FORT ST, SUITE 1, SOUTHGATE, MI 48195-1367
(734) 282-5444
(734) 282-4899
Mailing address
5533 CRISPIN WAY RD, W BLOOMFIELD, MI 48323-3407
(313) 717-8932
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA057471
MI
207R00000X
Internal Medicine Physician
Primary
MA057471
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3503774
—
MI
05
—
4627560
—
MI
Enumeration date
03/31/2006
Last updated
04/04/2023
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