| Raid Al-khersan | |
|
17327 Stonebrook Dr Northville MI 48168-4325 | |
| (248) 849-4226 | |
| (248) 849-4240 |
| Full Name | Raid Al-khersan |
|---|---|
| Speciality | Internal Medicine |
| Location | 17327 Stonebrook Dr, Northville, Michigan |
| Authorized Official Name and Position | Raid Al-khersan (OWNER) |
| Authorized Official Contact | 2488494226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raid Al-khersan 17327 Stonebrook Dr Northville MI 48168-4325 Ph: (248) 849-4226 | Raid Al-khersan 17327 Stonebrook Dr Northville MI 48168-4325 Ph: (248) 849-4226 |
| NPI Number | 1396058442 |
|---|---|
| Provider Enumeration Date | 07/19/2010 |
| Last Update Date | 12/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396058442 | NPI | - | NPPES |
| 1134221625 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | () | Secondary |
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