Basic Information
| Provider Information | |||||||||
| NPI: | 1528637196 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL-GAMMAL | ||||||||
| FirstName: | AHMAD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 SCHAEFER RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481263743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6472193018 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4700 SCHAEFER RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481263743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3135937000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2021 | ||||||||
| LastUpdateDate: | 06/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4351048806 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.