Provider Demographics
NPI:1114484540
Name:MAAN EKKAH MD PC
Entity type:Organization
Organization Name:MAAN EKKAH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EKKAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-925-0948
Mailing Address - Street 1:8355 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-4618
Mailing Address - Country:US
Mailing Address - Phone:248-666-6005
Mailing Address - Fax:
Practice Address - Street 1:8355 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-4618
Practice Address - Country:US
Practice Address - Phone:248-666-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty