Individual
FADI SAMER MOUSA AYOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22250 PROVIDENCE DR. 3PMB SUITE #301, 22250 PROVIDENCE DR. 3PMB SUITE #301, SOUTHFIELD, MI 48075-4818
(248) 849-3281
(248) 849-5449
Mailing address
22250 PROVIDENCE DR. 3PMB SUITE #301, 22250 PROVIDENCE DR. 3PMB SUITE #301, SOUTHFIELD, MI 48075-4818
(248) 849-3281
(248) 849-5449
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4351052672
MI
Other
Enumeration date
05/20/2024
Last updated
07/24/2024
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