Organization
ORMC ANESTHESIOLOGIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR F. FULEIHAN MD (AUTHORIZED REPRESENTATIVE)
(313) 993-0822
Entity
Organization
Contact information
Practice address
22401 FOSTER WINTER DR, SOUTHFIELD, MI 48075-3724
(248) 423-5151
(517) 787-4146
Mailing address
P O BOX 1123, 255 WEST MICHIGAN AVENUE, JACKSON, MI 49204-1123
(800) 516-5315
(517) 787-7365
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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