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Individual

GHASSAN DALLOUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
37799 PROFESSIONAL CENTER DR STE 105, LIVONIA, MI 48154-1123
(248) 878-3171
(248) 928-0916
Mailing address
PO BOX 182005, SHELBY TWP, MI 48318-2005
(248) 878-3171
(248) 928-0916

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
4301087543
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447466016
MI
01
4301087543
STATE LICENSE
Enumeration date
05/14/2007
Last updated
04/18/2024
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