Provider Demographics
NPI:1144198144
Name:ALHOUSSEINI GOGA TAMBARI, KALILAN (NIAMEY)
Entity type:Individual
Prefix:MR
First Name:KALILAN
Middle Name:
Last Name:ALHOUSSEINI GOGA TAMBARI
Suffix:
Gender:M
Credentials:NIAMEY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 GLENCOE HILLS DR APT 7
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-3029
Mailing Address - Country:US
Mailing Address - Phone:734-544-3050
Mailing Address - Fax:
Practice Address - Street 1:555 TOWNER ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5723
Practice Address - Country:US
Practice Address - Phone:734-544-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker