Basic Information
| Provider Information | |||||||||
| NPI: | 1063036960 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMAL | ||||||||
| FirstName: | HAWRA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ACADEMIC INTERNAL MEDICINE 22250 PROVIDENCE DR | ||||||||
| Address2: | 3PMB SUITE #301 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480754818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488493281 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | ACADEMIC INTERNAL MEDICINE 22250 PROVIDENCE DR | ||||||||
| Address2: | 3PMB SUITE #301 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480754818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488493281 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2020 | ||||||||
| LastUpdateDate: | 06/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4351046974 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.