Wafa Odeh, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301058134 Issued in MI

Practice address

15777 Northline Rd
Southgate, MI 48195-2385

Phone

(734) 246-8100

NPI assigned

Feb 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Trenton, MI
  • NPI 1740230648
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1780657676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15777 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15777 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952385",
            "telephone_number": "734-246-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEH",
        "first_name": "WAFA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301058134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wodeh108909@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "15777 Northline Rd",
            "city": "Southgate",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481952385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Oakwood Healthcare Group II, LLC
• Michael Oberg
• OBGYN Healthcare PC
• Susan Lynn Obrien, LPC
• Bana Odeh, PT, DPT
• Rachel Elizabether Odett, B.A. SST
• Suzanne Ogunkunle, LLMSW
• Allyn Aleve Marie Cuevas Ojeda, M.S., L.L.P.
• Jessica Lee Okkerse, LMSW, CPSM
• Carol Ann Oleksiak, LMSW, ACSW

• Internal Medicine Physician in Southgate, MI
• Providers in Southgate, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.