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Individual

DR. FADI SALLOUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5516
(248) 338-5547
Mailing address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5516
(248) 338-5547

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301065435
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10117120003
WELLNESS
MI
01
110174571
RAILROAD
MI
05
347943610
MI
01
4537
CAPE
MI
01
FS065435
BCBS
MI
01
P102773
BCN
MI
Enumeration date
06/04/2006
Last updated
07/15/2010
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