Individual
DR. WADDAH MASKOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2417
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
E-8285
AR
208M00000X
Hospitalist Physician
51037
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01061491A
LICENSE
IN
01
—
51037-020
STATE LICENSE
WI
Enumeration date
09/25/2006
Last updated
03/17/2018
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