Individual
DR. ISSAM S ASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3435 ORCHARD LAKE RD, KEEGO HARBOR, MI 48320
(313) 286-3277
Mailing address
7188 WHITE OAK DR, WEST BLOOMFIELD, MI 48323
(248) 444-9044
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301078808
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F317940
BCBS OF MICHIGAN
MI
01
—
383601519
TAX ID
MI
01
—
700H231390
BCBSM GROUP NUMBER
MI
Enumeration date
06/26/2007
Last updated
10/11/2012
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