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Individual
DR. ISSAM S ASAD
Active
Individual
DR. ISSAM S ASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301078808
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F317940
BCBS OF MICHIGAN
MI
01
—
383601519
TAX ID
MI
01
—
700H231390
BCBSM GROUP NUMBER
MI
Enumeration date
06/26/2007
Last updated
10/11/2012
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