Individual
SALMAN A FATEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1080 HARRINGTON ST, SUITE 202, MOUNT CLEMENS, MI 48043-2901
(586) 493-3440
(586) 493-3445
Mailing address
1080 HARRINGTON ST, SUITE 202, MOUNT CLEMENS, MI 48043-2901
(586) 493-3440
(586) 493-3445
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
5101017226
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5101017226
STATE LICENSE ID
MI
01
—
5315043762
CONTROLLED DRUG LICENSE
MI
01
—
5630982
BCBSM
MI
Enumeration date
05/08/2007
Last updated
02/18/2016
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