Provider Demographics
NPI:1588407555
Name:SEYHIBRAHIM, ALAA (MBBS)
Entity type:Individual
Prefix:MISS
First Name:ALAA
Middle Name:
Last Name:SEYHIBRAHIM
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 COOLIDGE HWY
Mailing Address - Street 2:APT. 203 UNIT #053203
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-551-3000
Practice Address - Fax:248-551-2032
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2025-03-20
Deactivation Date:2025-01-31
Deactivation Code:
Reactivation Date:2025-03-20
Provider Licenses
StateLicense IDTaxonomies
MI4351052348APP4390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program