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Ahmad Jamal Ali Shrouf

Internal Medicine

Allopathic & Osteopathic Physicians

3601 W. 13 Mile Road, Gme Office, Royal Oak, MI 48073

PECOS Enrollment

This provider is enrolled in PECOS as AHMAD SHROUF.

Based on the most recent information from CMS, provider Ahmad Jamal Ali Shrouf is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:21 AM.

Profile Details

Provider ID
1023866787
Provider Type
Individual
Full Name
Shrouf, Ahmad Jamal Ali
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/8/2024
Last Updated
7/18/2024

Contact Information

Practice Location

3601 W. 13 Mile Road, Gme Office, Royal Oak, MI 48073

(248) 551-3000

(248) 551-9425

Mailing Location

3601 W. 13 Mile Road, Gme Office, Royal Oak, MI 48073

(248) 551-3000

(248) 551-9425

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 4351052898 Michigan
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License 4351052898 Michigan

Ahmad Jamal Ali Shrouf

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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Kossak, Olha Anna

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Lee, Denise Y

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