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Individual

FADYA SISO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1701 SOUTH BLVD E STE 110, ROCHESTER HILLS, MI 48307-6118
(248) 853-0803
Mailing address
13265 BOCA GRANDE DR, STERLING HEIGHTS, MI 48312-3208
(248) 506-0594

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011431
MI

Other

Enumeration date
02/17/2022
Last updated
08/30/2023
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