Individual
OMAR AYMAN SOUBANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3901 CHRYSLER SERVICE DRIVE, DETROIT, MI 48201-2167
(313) 577-7523
(313) 577-8823
Mailing address
3901 CHRYSLER SERVICE DRIVE, DETROIT, MI 48212
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5101026891
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
04/24/2019
Last updated
07/24/2023
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