Individual
DR. ADIB RODOLF MOUSSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-5535
Mailing address
3737 BEAUBIEN ST, APT # 909, DETROIT, MI 48201-2152
(313) 808-0076
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301090450
MI
207L00000X
Anesthesiology Physician
Primary
4301090450
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15928
—
ND
Enumeration date
05/08/2008
Last updated
10/24/2023
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