Basic Information
Provider Information
NPI: 1891392577
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABDULKARIM
FirstName: INAAM
MiddleName:  
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Credential:  
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Mailing Information
Address1: 1635 LEAIRD DR
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481051822
CountryCode: US
TelephoneNumber: 7342721890
FaxNumber:  
Practice Location
Address1: 1010 E WEST MAPLE RD
Address2:  
City: WALLED LAKE
State: MI
PostalCode: 483903571
CountryCode: US
TelephoneNumber: 2483132900
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/05/2020
LastUpdateDate: 10/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 10/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X6362009204MIY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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