Individual
SALAH FARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27211 LAHSER RD, STE # 200, SOUTHFIELD, MI 48034-8469
(248) 358-4982
(248) 358-5125
Mailing address
1111 MEDICAL PLAZA DRIVE, SUITE 250, THE WOODLANDS, TX 77380-3477
(281) 296-8788
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
Q3670
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-0F33636-0
BCBSM
MI
01
—
1346398971
GRP NPI
MI
01
—
20-5485614
TAX ID
MI
01
—
4301087647
LICENSE
MI
Enumeration date
05/07/2008
Last updated
09/11/2015
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