Individual
DR. SAMER MOSSALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1046 N MONROE ST, MONROE, MI 48162-3113
(734) 457-9034
(734) 457-9037
Mailing address
1046 N MONROE ST, MONROE, MI 48162-3113
(734) 457-9034
(734) 457-4030
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5101012934
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03570
PARAMOUNT
MI
01
—
05500
HEALTHPLAN OF MICHIGAN
MI
05
—
114734032
—
MI
01
—
1655800434
BLUE CROSS BLUE SHIELD
MI
01
—
7112004
AETNA
MI
01
—
P00210239
RAILROAD MEDICARE
MI
Enumeration date
11/15/2005
Last updated
10/01/2025
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