M. Redwan Kubaisi, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301037002 Issued in MI

Practice address

8449 Park Ave
Allen Park, MI 48101-1594

Phone

(313) 383-7830

Fax

(313) 383-7831

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• M. Redwan Kubaisi MD PC

  • Surgery Physician
  • Allen Park, MI
  • NPI 1528102571
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1700920758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8449 PARK AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011594",
            "telephone_number": "313-383-7830",
            "fax_number": "313-383-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8449 PARK AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011594",
            "telephone_number": "313-383-7830",
            "fax_number": "313-383-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBAISI",
        "first_name": "M.",
        "middle_name": "REDWAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301037002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Kleinschmidt, ATC
• Praveena Koneru, MD
• Jane Kramar, M.D.
• Theresa Marie Kramer
• Andrew Peter Kronk, PH.D.
• Jennifer Laduke
• Ronald Lambert, P.A.
• Lawrence a Hansen MD PLC
• Susan Carol Lazenby
• Byung Jae Jack Lee, DMD

• Surgery Physician in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.