Organization
WAFA A ELHASSAN MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA EL MASRI (CREDENTIALING COORDINATOR)
(248) 215-0048
Entity
Organization
Contact information
Practice address
4020 VENOY RD STE 300, WAYNE, MI 48184-1899
(734) 589-1090
(734) 589-1091
Mailing address
39466 DORCHESTER CIR, CANTON, MI 48188-5000
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699115535
—
MI
Enumeration date
09/08/2019
Last updated
01/29/2025
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