1447457734 NPI number — EMAD ALATASSI MD, P.C.

Table of content: (NPI 1447457734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447457734 NPI number — EMAD ALATASSI MD, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMAD ALATASSI MD, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447457734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43750 GARFIELD RD
Provider Second Line Business Mailing Address:
SUITE 211
Provider Business Mailing Address City Name:
CLINTON TOWNSHIP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48038-1135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-996-9975
Provider Business Mailing Address Fax Number:
586-228-4533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18263 E 10 MILE RD
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48066-5805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-778-3478
Provider Business Practice Location Address Fax Number:
586-778-3496
Provider Enumeration Date:
06/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALATASSI
Authorized Official First Name:
EMAD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
586-778-3478

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0200X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RS0012X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1528018256 . This is a "NPI EMAD ALATASSI MD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: EA069292 . This is a "LICENSE EMAD ALATASSI MID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0826142 . This is a "BCBS PIN EMAD ALATASSI MD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 290H239650 . This is a "BCBS PIN NUMBER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: FS087234 . This is a "LICENSE FADI-JEAN SAAD, M" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1174573816 . This is a "NPI FADI-JEAN SAAD, MD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0825742 . This is a "BCBS PIN FADIJEAN SAAD MD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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