Individual
IHAB JUBRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6256
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
27575
AL
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
4301111677
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009939897
—
AL
05
—
04377591
—
MS
05
—
277115200
—
FL
01
—
51538077
BCBS CENTER ST
AL
01
—
51538078
BCBS SPRINGHILL AVE
AL
Enumeration date
10/13/2006
Last updated
10/05/2022
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