Basic Information
| Provider Information | |||||||||
| NPI: | 1174960371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DABAJA | ||||||||
| FirstName: | WAEL | ||||||||
| MiddleName: | HUSSEIN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11885 E 12 MILE RD STE 300A | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480933467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865826630 | ||||||||
| FaxNumber: | 5865826631 | ||||||||
| Practice Location | |||||||||
| Address1: | 23050 WEST RD STE 120 | ||||||||
| Address2: | |||||||||
| City: | BROWNSTOWN TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481831470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346711510 | ||||||||
| FaxNumber: | 7346711570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2013 | ||||||||
| LastUpdateDate: | 05/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 5101020582 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 5101020582 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.