Doctor Name: | DR. ISSAM S ASAD |
NPI Number: | 1396941332 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4301078808 |
Business Practice Address: | 3435 Orchard Lake Rd Keego Harbor, MI - 48320 |
Business Phone Number: | 3132863277 |
Business Fax Number: | |
Mailing Address: | 7188 White Oak Dr, WEST BLOOMFIELD |
State: | MI |
Postal Code: | 48323 |
Phone Number: | 2484449044 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2007 |
NPI Last Update Date: | 10/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301078808 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |