Ahmad Abukhader, DO

Key facts

NPI

1194466342

Entity type

Individual (NPI type 1)

Primary specialty

Surgery Physician 208600000X

License

1194466342 (MI)

Practice address

2333 Biddle Ave
Wyandotte, MI 48192-4668

Phone

(734) 246-8004

NPI assigned

Apr 3, 2022

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: aabukhader785025@direct.hfhs.org

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 20, 2022.

{
    "created_epoch": "1648944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1194466342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUKHADER",
        "first_name": "AHMAD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-03",
        "last_updated": "2022-07-20",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "1194466342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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