Individual
SAMIR DABBOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22060 BEECH ST, SUITE 200, DEARBORN, MI 48124-2847
(313) 228-0505
(313) 228-0506
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1863
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301038418
MI
207RC0000X
Cardiovascular Disease Physician
Primary
4301038418
MI
207RI0011X
Interventional Cardiology Physician
4301038418
MI
207UN0901X
Nuclear Cardiology Physician
4301038418
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060007967
MEDICARE RR
MI
01
—
0Q26305001
BLUECROSSBLUESHIELD OF MI
MI
05
—
1572450
—
MI
01
—
P41685
BLUECARENETWORK
MI
Enumeration date
06/23/2006
Last updated
10/22/2020
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