Individual
DR. CASEM BALLOUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(312) 480-5473
Mailing address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-8040
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
4301510121
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/18/2021
Last updated
07/20/2023
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