Provider Demographics
NPI:1730923772
Name:ALHALLAK TONBR, BARAA (MD)
Entity type:Individual
Prefix:
First Name:BARAA
Middle Name:
Last Name:ALHALLAK TONBR
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 1:27321 DEQUINDRE RD APT 25
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3455
Mailing Address - Country:US
Mailing Address - Phone:331-289-9172
Mailing Address - Fax:
Practice Address - Street 1:11885 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3474
Practice Address - Country:US
Practice Address - Phone:586-582-6630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351053631207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine