Individual
FATINA MASRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13530 MICHIGAN AVE, SUITE 150, DEARBORN, MI 48126-3574
(313) 945-9800
(313) 945-9184
Mailing address
13530 MICHIGAN AVE STE 400, DEARBORN, MI 48126-3575
(313) 945-9800
(313) 945-9184
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
4301053444
MI
208D00000X
General Practice Physician
Primary
FM053444
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0808276302
BCBS IND
MI
05
—
1013180322
—
MI
Enumeration date
04/08/2008
Last updated
03/10/2020
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