Basic Information
| Provider Information | |||||||||
| NPI: | 1922339977 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALFARES | ||||||||
| FirstName: | SOHA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14500 HALL RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483131229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862472700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2421 MONROE ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481243043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3134470888 | ||||||||
| FaxNumber: | 3134584004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2010 | ||||||||
| LastUpdateDate: | 05/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 430194675 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.