Individual
RANA TABASSUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3250
Mailing address
1125 MEADOW CREEK CT, VERNON HILLS, IL 60061-2562
(248) 952-1440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301099130
MI
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
57735-20
WI
Other
Enumeration date
07/14/2011
Last updated
05/21/2018
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