Individual
FATHELRAHMAN OMER ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2040 MONROE ST, SUITE # 207, DEARBORN, MI 48124-2950
(313) 278-5836
(313) 278-5846
Mailing address
2040 MONROE ST, SUITE # 207, DEARBORN, MI 48124-2950
(313) 278-5836
(313) 278-5846
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301075097
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4787887
—
MI
Enumeration date
01/26/2006
Last updated
09/09/2013
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