Individual
MR. MAHMOUD AHMED DWAIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
7071 ORCHARD LAKE RD STE 220, WEST BLOOMFIELD, MI 48322-3683
(248) 856-6033
(248) 855-6034
Mailing address
PO BOX 871354, CANTON, MI 48187-6354
(248) 855-6033
(248) 855-6034
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704184761
MI
363LF0000X
Family Nurse Practitioner
Primary
4704184761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881122935
—
MI
Enumeration date
06/01/2017
Last updated
07/02/2021
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