Basic Information
| Provider Information | |||||||||
| NPI: | 1699968529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALFA | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ALEKE | ||||||||
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| Credential: | MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | 700 KMS PLACE | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349362047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 EAST MEDICAL CENTER DR | ||||||||
| Address2: | 2ND FLOOR TAUBMAN CTR RECP G | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481090222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347635828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2007 | ||||||||
| LastUpdateDate: | 08/23/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 4301089151 | MI | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 4301089151 | MI | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.