Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 4301082409 | MI |
Y | 208600000X | Surgeon | 4301082409 | MI |
NPI | 1013127174 |
---|---|
Provider Name | Dr. Bellal Ali Joseph |
First Address | Dearborn, MI 48126-2848 |
Second Address | Detroit, MI 48202-2608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |