Individual
DR. SHADI M FAHS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
23855 MICHIGAN AVE, DEARBORN, MI 48124-1805
(313) 769-5656
(313) 769-5658
Mailing address
23855 MICHIGAN AVE, DEARBORN, MI 48124-1805
(313) 769-5656
(313) 769-5658
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101014583
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238601
MEDICARE RURAL HEALTH CLINIC NUMBER
MI
05
—
4938598
—
MI
01
—
CA1068
RAILROAD MEDICAER
MI
Enumeration date
01/11/2006
Last updated
12/09/2015
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