Provider Demographics
NPI:1598217770
Name:CHOUCAIR, MUSTAPHA MAJED (MD)
Entity type:Individual
Prefix:MR
First Name:MUSTAPHA
Middle Name:MAJED
Last Name:CHOUCAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 W. 13 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6712
Mailing Address - Country:US
Mailing Address - Phone:248-551-3000
Mailing Address - Fax:248-551-9425
Practice Address - Street 1:3601 W. 13 MILE ROAD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-551-3000
Practice Address - Fax:248-551-9425
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2022-07-01
Deactivation Date:2022-05-09
Deactivation Code:
Reactivation Date:2022-06-09
Provider Licenses
StateLicense IDTaxonomies
MI4351049625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine