Individual
SAMI A. MOUMNEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BLVD., DETROIT, MI 48202
(313) 916-7425
(313) 874-3623
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BLVD., DETROIT, MI 48202
(313) 916-7425
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301057311
MI
207R00000X
Internal Medicine Physician
4301057311
MI
208000000X
Pediatrics Physician
Primary
4301057311
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312053010
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
SM057311
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/01/2006
Last updated
08/01/2012
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