Individual
IMAN FAYAK ISMAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20280 MIDDLEBELT RD, LIVONIA, MI 48152-2002
(248) 987-1270
Mailing address
4691 ROLLING RIDGE RD, WEST BLOOMFIELD, MI 48323-3343
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008934
MI
Other
Enumeration date
01/08/2019
Last updated
04/14/2022
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