Provider Demographics
NPI:1871894196
Name:ALQADHI, LOUZA (PA-C)
Entity type:Individual
Prefix:
First Name:LOUZA
Middle Name:
Last Name:ALQADHI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17197 N LAUREL PARK DR
Mailing Address - Street 2:SUITE 161
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2680
Mailing Address - Country:US
Mailing Address - Phone:734-338-8300
Mailing Address - Fax:
Practice Address - Street 1:17197 N LAUREL PARK DR
Practice Address - Street 2:SUITE 161
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2680
Practice Address - Country:US
Practice Address - Phone:734-338-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005857363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant