Individual
DR. FAWAZ AL-EJEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24623 GREENFIELD RD, SOUTHFIELD, MI 48075-3058
(248) 290-3111
(248) 290-3100
Mailing address
PO BOX 77000 DEPARTMENT 771267, DETROIT, MI 48277-1267
(248) 290-3111
(248) 290-3100
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301056772
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3482020
—
MI
Enumeration date
02/16/2006
Last updated
12/08/2022
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