Doctor Name: | DR. ALLIE DAKROUB |
NPI Number: | 1003174202 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 50 E Canfield St Detroit, MI - 482011804 |
Business Phone Number: | 3137456960 |
Business Fax Number: | 3139667305 |
Mailing Address: | 4201 Saint Antoine St, Uhc 5c DETROIT |
State: | MI |
Postal Code: | 482012153 |
Phone Number: | 3135774342 |
Fax Number: | 3137454707 |
NPI Enumeration Date: | 04/25/2012 |
NPI Last Update Date: | 06/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |