Individual
AYESHA FATIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 W 13 MILE RD, ROYAL OAK, MI 48073-6770
(248) 551-0311
Mailing address
3535 W 13 MILE RD, ROYAL OAK, MI 48073-6770
(248) 551-0311
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD12288
RI
2080P0206X
Pediatric Gastroenterology Physician
Primary
4301079789
MI
2080P0206X
Pediatric Gastroenterology Physician
MD12288
RI
Other
Enumeration date
04/23/2007
Last updated
10/22/2020
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