Individual
FAESAL ELBAKOUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3901 BEAUBIEN, CHILDREN'S HOSPITAL OF MI, DETROIT, MI 48201
(313) 966-8999
(313) 993-0390
Mailing address
4201 ST. ANTOINE, UNIVERSITY PEDIATRICIANS UHC 5D MAILBOX# 226, DETROIT, MI 48201
(313) 966-5051
(313) 966-0665
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301106817
MI
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
4301106817
MI
Other
Enumeration date
11/17/2014
Last updated
08/23/2022
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