Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 50742-020 | WI |
N | 111NI0900X | Internist | 50742-020 | WI |
N | 207RC0000X | Internist - Cardiovascular Disease | 01061906A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 50742-020 | WI |
N | 207RC0000X | Internist - Cardiovascular Disease | MD429763 | PA |
N | 207RI0011X | Interventional Cardiology | 4301106371 | MI |
Y | 207RI0011X | Interventional Cardiology | 50742-020 | WI |
N | 207RI0011X | Interventional Cardiology | MD429763 | PA |
NPI | 1093762205 |
---|---|
Provider Name | Dr. Khaldoon Alaswad |
First Address | Detroit, MI 48202 |
Second Address | Detroit, MI 48202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 11/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34937500 | (05) | WI |
G63819 | (02) |