Individual
EMILE BASEM MUALLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301506639
MI
208000000X
Pediatrics Physician
4351044275
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4351044275
LIMITED EDUCATION LICENSE
MI
01
—
5315205335
CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
05/17/2019
Last updated
08/02/2023
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