Basic Information
| Provider Information | |||||||||
| NPI: | 1407088123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALCHAKAKI | ||||||||
| FirstName: | ABDULRAZAK | ||||||||
| MiddleName: | FISAL | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28411 NORTHWESTERN HWY | ||||||||
| Address2: | SUITE 1050 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480345544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483544709 | ||||||||
| FaxNumber: | 2483544807 | ||||||||
| Practice Location | |||||||||
| Address1: | 28411 NORTHWESTERN HWY | ||||||||
| Address2: | SUITE 1050 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480345544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483544709 | ||||||||
| FaxNumber: | 2483544807 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2009 | ||||||||
| LastUpdateDate: | 12/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301094495 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 4301094495 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 4301094495 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | 4301094495 | MI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.