Organization
KASSEM M CHARARA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASSEM M CHARARA MD (PRESIDENT)
(313) 581-1222
Entity
Organization
Contact information
Practice address
6211 CHASE RD, DEARBORN, MI 48126-2405
(313) 581-1222
(313) 581-6657
Mailing address
6211 CHASE RD, DEARBORN, MI 48126-2405
(313) 581-1222
(313) 581-6657
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301060523
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0826564
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/03/2008
Last updated
04/20/2008
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