Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 4301502810 | MI |
NPI | 1164037735 |
---|---|
Provider Name | Dr. Mamdouh Dakhel A Alahmadi |
First Address | Riyadh, SAUDI ARABIA 11595 |
Second Address | Detroit, MI 48201-2196 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2020 |
Last Update Date | 10/09/2020 |