Individual
DR. FAYEZ KOTOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.B.A.
Contact information
Practice address
5050 VILLA LINDE PKWY STE A, FLINT, MI 48532-3436
(810) 230-7400
(810) 230-7440
Mailing address
PO BOX 846, GRAND BLANC, MI 48480-0846
(810) 230-7400
(810) 230-7440
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301098964
MI
207LA0401X
Addiction Medicine (Anesthesiology) Physician
4301098964
MI
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
4301098964
MI
207LP3000X
Pediatric Anesthesiology Physician
4301098964
MI
208VP0000X
Pain Medicine Physician
4301098964
MI
208VP0014X
Interventional Pain Medicine Physician
Primary
4301098964
MI
Other
Enumeration date
03/17/2011
Last updated
11/16/2015
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