Basic Information
| Provider Information | |||||||||
| NPI: | 1710417209 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARKHO | ||||||||
| FirstName: | SULAIMAN | ||||||||
| MiddleName: | JAMIL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21460 BOURNEMOUTH ST APT 101A | ||||||||
| Address2: | |||||||||
| City: | HARPER WOODS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482252339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2012209977 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4201 SAINT ANTOINE ST # 9C | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137455146 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2017 | ||||||||
| LastUpdateDate: | 06/15/2017 | ||||||||
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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 | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.