Provider Demographics
NPI:1023131547
Name:MAHFOUZ, ABDUL RAZZAK (MD)
Entity type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:RAZZAK
Last Name:MAHFOUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3350 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1828
Mailing Address - Country:US
Mailing Address - Phone:248-851-0514
Mailing Address - Fax:248-851-7133
Practice Address - Street 1:24230 KARIM BLBD
Practice Address - Street 2:SUITE# 125
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2960
Practice Address - Country:US
Practice Address - Phone:248-474-2700
Practice Address - Fax:248-474-2721
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301033059208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery