Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301085811 | MI |
Y | 111NI0900X | Internist | 4301085811 | MI |
NPI | 1003021387 |
---|---|
Provider Name | Nabil Alkhoury Fallouh |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 20/02/2012 |