Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 4301061905 | MI |
NPI | 1114998432 |
---|---|
Provider Name | Dr. Maha Dabbagh |
First Address | Garden City, MI 48135-2927 |
Second Address | Garden City, MI 48135-2927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4206587 | (05) | MI |