Individual
DR. ANTONIOUS S ATTALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25195 KELLY ROAD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Mailing address
25195 KELLY ROAD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301094176
MI
207R00000X
Internal Medicine Physician
BP10024918
TX
207RC0000X
Cardiovascular Disease Physician
4301094176
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301094176
MI
207UN0901X
Nuclear Cardiology Physician
4301094176
MI
Other
Enumeration date
12/08/2008
Last updated
03/02/2015
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