Individual
GHALIB Y TALIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
44555 WOODWARD AVE, SUITE 301, PONTIAC, MI 48341-5031
(246) 338-4040
(248) 858-3871
Mailing address
44555 WOODWARD AVE, SUITE 301, PONTIAC, MI 48341-5031
(246) 338-4040
(248) 858-3871
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
044127
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1552573
—
MI
01
—
2806367791
BLUE SHIELD
MI
Enumeration date
10/31/2005
Last updated
08/21/2013
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