Individual
DR. YASMIN FAROUK TOOTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1601
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
L2014754
MI
2086S0127X
Trauma Surgery Physician
Primary
036147564
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214881
MULTI SPECIALTY GROUP PTAN
IL
Enumeration date
06/01/2011
Last updated
01/08/2021
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