ALAA EDDIN TAHBOUB (NPI# 1689225443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689225443 |
| Entity Type | Individual |
| Full Name | ALAA EDDIN TAHBOUB |
| Credential | PA-C |
| Practice Address |
4771 Michigan Ave Detroit MI 48210-9718 |
| Mailing Address |
17827 Maisons Dr Clinton Twp MI 48038-3805 |
| Practice Telephone | 3138972600 |
| Practice Fax Number | 3138972424 |
| Mailing Telephone | 8108456450 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601009631 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4771 MICHIGAN AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48210-9718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477523892 | Jerry Uzansky | Family Medicine | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2006-01-26 |
| 1821600180 | Gabriela De Vita Menegatti | Family Medicine | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2020-08-18 |
| 1417407438 | Aaron Michael Lammers | Physician Assistant | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2016-10-13 |
| 1134520042 | Matthew Nedwicki | Family Medicine | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2014-09-10 |
| 1689940397 | Heart and Vascular Care, P.C. | Internal Medicine | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2012-03-27 |
| 1831321090 | John Raymond Zawacki | Physician Assistant | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2009-08-20 |
| 1639301898 | John Charles Stabb | Physician Assistant | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2009-08-20 |
| 1285813154 | Junction Clinic | Family Medicine | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2007-10-29 |
| 1164492500 | Jerome Sitner | Family Medicine | 4771 Michigan Ave, Detroit, MI 48210-3247 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518517606 | Southwest Solutions | Counselor | 5716 Michigan, Detroit, MI 48210 | 2019-09-19 |
| 1942676150 | Audrey Hall | Case Manager/Care Coordinator | 6576 Woodrow St, Detroit, MI 48210 | 2015-08-12 |
| 1952705147 | Barbara Denise Mccowin-west | Technician, Other | 6900 Mcgraw, Detroit, MI 48210 | 2014-10-16 |
| 1922259456 | Dawn Marie Sanderson | Counselor | 5613 Livernois, Detroit, MI 48210 | 2008-10-02 |
| 1366552804 | American Indian Health and Family Services of Southeastern Mi Inc | In Home Supportive Care | 4880 Lawndalestreet, Detroit, MI 48210 | 2006-08-30 |
| 1912950163 | Irwin Rabinowitz | Pharmacist | Junction Clinic Pharmacy 4771 Michigan Ave., Detroit, MI 48210 | 2006-05-18 |
| 1295229110 | Anne Marie Galus | Dentist | 5716 Michigan Ave, Detroit, MI 48210 | 2018-06-15 |
| 1124547948 | Sarah Fay Walsworth | Physician Assistant | 5716 Michigan Ave, Detroit, MI 48210 | 2017-09-13 |
| 1538305909 | Barbara Ann Menzies-williams | Internal Medicine | 6550 W Warren Ave, Detroit, MI 48210 | 2009-01-06 |
| 1760678437 | Clement T Piaskowski | Optometrist | 7433 Michigan Ave, Detroit, MI 48210 | 2007-09-17 |
| Find all providers in zip 48210 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831340355 | Antonia L Navarro | Physician Assistant | University Physician Group Oncology, 4100 John R, Detroit, MI 48201-2013 | 2008-10-02 |
| 1104974443 | Amy B Oatfield | Physician Assistant | Henry Ford Hospital Trauma and Critical Care Cfp-1, 2799 West Grand Blvd, Detroit, MI 48202 | 2007-01-05 |
| 1295750677 | Ingrid Dominic Mitchell | Physician Assistant | 18254 Livernois Ave Ste 1, Detroit, MI 48221-4214 | 2006-07-13 |
| 1952397291 | Kelly Michelle Brown | Physician Assistant | 22151 Moross Rd Ste 320, Maternal Fetal Medicine St John Hospital & Medical Cen, Detroit, MI 48236-2196 | 2005-09-22 |
| 1467067975 | Jerrica Clemens | Physician Assistant | 4100 Woodward Ave, Detroit, MI 48201-2173 | 2020-09-11 |
| 1679195176 | Shane Michael Dignan | Physician Assistant | 259 Mack Ave, Detroit, MI 48201-2427 | 2020-05-07 |
| 1174154843 | Weston Alexander Davis | Physician Assistant | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-01-30 |
| 1609338367 | Aanchal Bhojwani | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2019-04-02 |
| 1952883068 | Jeremy Lynn Herzberg | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2018-09-05 |
| 1124508122 | Chadius M Milton | Physician Assistant | 18254 Livernois Ave Ste 1, Detroit, MI 48221 | 2018-08-19 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.