Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 4301101010 | MI |
N | 2080P0210X | Pediatric Nephrologist | MT211597 | PA |
NPI | 1831445733 |
---|---|
Provider Name | Dr. Abdulla Ehlayel |
First Address | Philadelphia, PA 19104-4319 |
Second Address | Detroit, MI 48201-2119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2012 |
Last Update Date | 24/06/2016 |