Individual
HOUSSAM M FADLALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
6500 SCHAEFER RD, SUITE A, DEARBORN, MI 48126
(313) 584-7900
(313) 584-4411
Mailing address
6500 SCHAEFER RD, SUITE A, DEARBORN, MI 48126-1813
(313) 584-7900
(313) 584-4411
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003142
MI
Other
Enumeration date
09/16/2005
Last updated
05/08/2017
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