Organization
EASTSIDE TRAUMA & SPECIALTY SURGEONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDELKADER HAWASLI MD (PRESIDENT)
(586) 774-8811
Entity
Organization
Contact information
Practice address
24911 LITTLE MACK AVE, SUITE B, SAINT CLAIR SHORES, MI 48080-3200
(586) 774-8811
(586) 774-6773
Mailing address
24911 LITTLE MACK AVE, SUITE B, SAINT CLAIR SHORES, MI 48080-3200
(586) 774-8811
(586) 774-6773
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H20098
BCBSM GROUP #
MI
Enumeration date
05/16/2007
Last updated
08/22/2020
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