# FADI SALLOUM MD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** IMPACT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053510446
- **Authorized official:** DR. FADI SALLOUM MD (OWNER)
- **Authorized official phone:** (248) 267-0135

## Contact information

- **Practice address:** 50 N PERRY ST, PONTIAC, MI 48342-2217
- **Practice address phone:** (248) 338-5516
- **Practice address fax:** (248) 338-5547
- **Mailing address:** PO BOX 869, BLOOMFIELD HILLS, MI 48303-0869
- **Mailing address phone:** (248) 267-0135
- **Mailing address fax:** (248) 338-5547

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 4301065435 | MI | Yes |

## Other

- **Enumeration date:** 07/16/2007
- **Last updated:** 08/07/2013