Mamdouh Abdulrazzak MD PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

4301063026 Issued in MI

Legal business name

MAMDOUH ABDULRAZZAK MD PC

Practice address

3200 Greenfield Rd
Suite 250
Dearborn, MI 48120-1802

Phone

(313) 563-3332

Fax

(313) 563-3342

NPI assigned

Aug 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mamdouh Abdulrazzak, MDNPI 1689649923

Title

President

Phone

(313) 563-3332

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mamdouh Abdulrazzak, M.D.

  • Neurology Physician
  • Dearborn, MI
  • NPI 1689649923
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1831403401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250341",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "480250341",
            "telephone_number": "313-563-3332",
            "fax_number": "313-563-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GREENFIELD RD",
            "address_2": "SUITE 250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201802",
            "telephone_number": "313-563-3332",
            "fax_number": "313-563-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMDOUH ABDULRAZZAK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "ABDULRAZZAK",
        "authorized_official_first_name": "MAMDOUH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-563-3332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301063026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MI3232",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hala Mallah, LMSW-C
• Srivenkata Sanjeev Mallareddy, PT
• Abdullah Mallisho, M.D.
• Sandhya Mallya, MA, LLP
• Orieyonna Lakisha Malone
• Managing Minds PLLC
• Stephanie Manard
• Janay Manciel
• Mancini Consulting L.L.C.
• Peter Mancini II, M.D.

• Neurology Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.